NPIMap

Organization Active NPI

Gove County Medical Center

  • Anesthesiology Physician
  • Quinter, KS
National Provider Identifier
1760566947
Registry record updated Jun 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
GOVE COUNTY MEDICAL CENTER
Practice address
520 W 5TH Street
Quinter, KS 67752-0129
Phone
(785) 754-3341
Fax
(785) 754-3329
NPI assigned
Oct 25, 2006
Last updated
Jun 25, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Richard Q Bergling
Title
Ceo
Phone
(785) 754-3341

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X H032001 KS
Anesthesiology Physician 207L00000X KS Primary

Addresses

Primary practice location

520 W 5TH Street
Quinter, KS 67752-0129

Mailing address

PO Box 129
520 W 5TH Street
Quinter, KS 67752-0129
Phone (785) 754-3341

Other identifiers 5

IdentifierTypeStateIssuer
043289OtherKSBCBS -ANES-ABBOTT
100099330CMedicaidKS
145129OtherKSBCBS-ANES-SEILER
144541OtherKSBCBS-ANES-WERTZ
144541OtherKSBCBS-WERTZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050419000860 KS Part B Supplier - Clinic/Group Practice 5799672499 Receives reassigned benefits from 9 practitioners
1 other NPI on this enrollment
Practice locations: Quinter, KS

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Gove County Medical CenterQuinter, KS, CCN 17Z367 Hospital Operational/Managerial Control (100%) Jan 1, 2015

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403654400000",
    "number": "1760566947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 129",
            "address_2": "520 W 5TH STREET",
            "city": "QUINTER",
            "state": "KS",
            "postal_code": "677520129",
            "telephone_number": "785-754-3341",
            "fax_number": "785-754-3329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 W 5TH STREET",
            "city": "QUINTER",
            "state": "KS",
            "postal_code": "677520129",
            "telephone_number": "785-754-3341",
            "fax_number": "785-754-3329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOVE COUNTY MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2014-06-25",
        "status": "A",
        "authorized_official_last_name": "BERGLING",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "Q",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "785-754-3341",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "KS",
            "license": "H032001",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "KS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS -ANES-ABBOTT",
            "identifier": "043289",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100099330C",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS-ANES-SEILER",
            "identifier": "145129",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS-ANES-WERTZ",
            "identifier": "144541",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS-WERTZ",
            "identifier": "144541",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Quinter, KS

Sources for this page

Verify at the official NPI Registry.