NPIMap

Organization Active NPI

Central Kansas Medical Center

Doing business as St Rose Anesthesia Pathology Services

  • Clinical Pathology/Laboratory Medicine Physician
  • Great Bend, KS
National Provider Identifier
1770834806
Registry record updated Sep 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Pathology/Laboratory Medicine PhysicianTaxonomy code 207ZP0105X
Legal business name
CENTRAL KANSAS MEDICAL CENTER
Doing business as
St Rose Anesthesia Pathology Services
Practice address
3515 Broadway Ave
Great Bend, KS 67530-3633
Phone
(620) 792-2511
NPI assigned
Sep 28, 2012
Last updated
Sep 28, 2012By the provider in NPPES
Organization subpart
Yes
Parent organization
CENTRAL KANSAS MEDICAL CENTER DBA ST. ROSE AMBULATORY & SURGERY CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 28, 2012

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

Authorized official

Name
Amanda Vaughan
Title
Cfo
Phone
(620) 272-2222

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Pathology/Laboratory Medicine Physician 207ZP0105X NU Primary

Addresses

Primary practice location

3515 Broadway Ave
Great Bend, KS 67530-3633

Mailing address

PO Box 388
Newton, KS 67114-0388

Other names 1

  • St Rose Anesthesia Pathology Services Doing business as

National Provider Directory

National Provider Directory
Part of
St Joseph Family Prac

NPI Registry JSON

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

{
    "created_epoch": "1348790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348790400000",
    "number": "1770834806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 388",
            "city": "NEWTON",
            "state": "KS",
            "postal_code": "671140388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3515 BROADWAY AVE",
            "city": "GREAT BEND",
            "state": "KS",
            "postal_code": "675303633",
            "telephone_number": "620-792-2511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL KANSAS MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CENTRAL KANSAS MEDICAL CENTER DBA ST. ROSE AMBULATORY & SURGERY CENTER",
        "enumeration_date": "2012-09-28",
        "last_updated": "2012-09-28",
        "status": "A",
        "authorized_official_last_name": "VAUGHAN",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "620-272-2222"
    },
    "taxonomies": [
        {
            "code": "207ZP0105X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St Rose Anesthesia Pathology Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Great Bend, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.