NPIMap

Organization Active NPI

South Central Kansas Regional Medical Center

Doing business as SCKMC Professional Services

  • Family Medicine Physician
  • Arkansas City, KS
National Provider Identifier
1770180457
Registry record updated Sep 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SOUTH CENTRAL KANSAS REGIONAL MEDICAL CENTER
Doing business as
SCKMC Professional Services
Practice address
6401 Patterson Pkwy
Arkansas City, KS 67005-5701
Phone
(620) 442-2500
NPI assigned
Oct 6, 2020
Last updated
Sep 6, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2023

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

Authorized official

Name
Jeff Bowman
Title
Ceo
Phone
(620) 441-5798

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

6401 Patterson Pkwy
Arkansas City, KS 67005-5701

Mailing address

6401 Patterson Pkwy
Arkansas City, KS 67005-5701
Phone (620) 442-2500

Other practice location 1

1300 E 5th Ave
Winfield, KS 67156-2407
Phone (620) 221-2300

Other names 1

  • SCKMC Professional Services Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040209000555 KS Part B Supplier - Clinic/Group Practice 1456245802 Receives reassigned benefits from 44 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Arkansas City, KS

Other NPIs on the same Medicare enrollment 6

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

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1601942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693958400000",
    "number": "1770180457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6401 PATTERSON PKWY",
            "city": "ARKANSAS CITY",
            "state": "KS",
            "postal_code": "670055701",
            "telephone_number": "620-442-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6401 PATTERSON PKWY",
            "city": "ARKANSAS CITY",
            "state": "KS",
            "postal_code": "670055701",
            "telephone_number": "620-442-2500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1300 E 5th Ave",
            "address_purpose": "LOCATION",
            "city": "Winfield",
            "state": "KS",
            "postal_code": "671562407",
            "country_code": "US",
            "telephone_number": "620-221-2300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SOUTH CENTRAL KANSAS REGIONAL MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-06",
        "last_updated": "2023-09-06",
        "certification_date": "2023-09-06",
        "status": "A",
        "authorized_official_last_name": "BOWMAN",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "620-441-5798"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SCKMC Professional Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Arkansas City, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.