Active NPI
Central Kansas Medical Center
- Certified Registered Nurse Anesthetist
- Great Bend, KS
National Provider Identifier
1790046019
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- Legal business name
- CENTRAL KANSAS MEDICAL CENTER
- Practice address
- 3515 Broadway Ave
Great Bend, KS 67530-3633 - Phone
- (620) 792-2511
- NPI assigned
- Jun 4, 2012
- Organization subpart
- Yes
- Parent organization
- CENTRAL KANSAS MEDICAL CENTER DBA ST. ROSE AMBULATORY & SURGERY CENTER
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 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
National Provider Directory
National Provider Directory- Part of
- Central KS Medical Cent
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1338768000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1347408000000",
"number": "1790046019",
"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": "2012-06-04",
"last_updated": "2012-09-12",
"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": "367500000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Nurse Anesthetist, Certified Registered",
"state": null,
"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 12, 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.