Central Kansas Medical Center

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

CENTRAL KANSAS MEDICAL CENTER

Doing business as

St. Joseph Family Medicine - Great Bend

Practice address

3520 Lakin Ave
Suite 103
Great Bend, KS 67530-3646

Phone

(620) 792-3345

Fax

(620) 792-3767

NPI assigned

Aug 15, 2008

Last updated

Nov 27, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Leanne Irsik

Title

Sr. VP/Site Administrator

Phone

(620) 786-6163

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• St. Joseph Family Medicine - Great Bend Doing business as

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

{
    "created_epoch": "1218758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353974400000",
    "number": "1801042353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3520 LAKIN AVE",
            "address_2": "SUITE 103",
            "city": "GREAT BEND",
            "state": "KS",
            "postal_code": "675303646",
            "telephone_number": "620-792-3767",
            "fax_number": "620-792-3767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3520 LAKIN AVE",
            "address_2": "SUITE 103",
            "city": "GREAT BEND",
            "state": "KS",
            "postal_code": "675303646",
            "telephone_number": "620-792-3345",
            "fax_number": "620-792-3767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL KANSAS MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-15",
        "last_updated": "2012-11-27",
        "status": "A",
        "authorized_official_last_name": "IRSIK",
        "authorized_official_first_name": "LEANNE",
        "authorized_official_title_or_position": "SR. VP/SITE ADMINISTRATOR",
        "authorized_official_telephone_number": "620-786-6163"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100080680H",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Joseph Family Medicine - Great Bend",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Central Kansas Medical Center (St Joseph Family Medicine/Great Bend)
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• Central Kansas Medical Center (Central Kansas Surgical Care)
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• Central Kansas Medical Center
• Central Kansas Medical Center (St Rose Medical Services)
• Central Kansas Medical Center

• Rural Health Clinic/Center in Great Bend, KS
• Providers in Great Bend, KS by specialty
• Rural Health Clinic/Center in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 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.