NPIMap

Organization Active NPI

Great Bend Regional Hospital LLC

Doing business as Central Kansas Family Practice

  • Family Medicine Physician
  • Great Bend, KS
National Provider Identifier
1811234818
Registry record updated Feb 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
GREAT BEND REGIONAL HOSPITAL LLC
Doing business as
Central Kansas Family Practice
Practice address
1309 Polk
Great Bend, KS 67530
Phone
(620) 792-5341
Fax
(620) 792-3702
NPI assigned
Jan 10, 2013
Last updated
Feb 12, 2013By the provider in NPPES
Organization subpart
Yes
Parent organization
GREAT BEND REGIONAL HOSPITAL, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 12, 2013

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

Authorized official

Name
Perry Milton Smith, MDNPI 1124029392
Title
Medical Director
Phone
(620) 792-5341

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

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

Addresses

Primary practice location

1309 Polk
Great Bend, KS 67530

Mailing address

1309 Polk
Great Bend, KS 67530
Phone (620) 792-5341

Other names 1

  • Central Kansas Family Practice Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Part of
Great Bend Reg Hospital LLC

Ownership & related parties

Change-of-ownership history 1

DateEventCounterparty
Aug 1, 2018 Change of OwnershipThis provider was the seller St. Rose Medical PavilionCCN 178576, KS, NPI 1073003992

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

Practitioners & affiliated clinicians

Practitioners 1

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": "1357776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360627200000",
    "number": "1811234818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1309 POLK",
            "city": "GREAT BEND",
            "state": "KS",
            "postal_code": "67530",
            "telephone_number": "620-792-5341",
            "fax_number": "620-792-3702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1309 POLK",
            "city": "GREAT BEND",
            "state": "KS",
            "postal_code": "67530",
            "telephone_number": "620-792-5341",
            "fax_number": "620-792-3702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT BEND REGIONAL HOSPITAL LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GREAT BEND REGIONAL HOSPITAL, LLC",
        "enumeration_date": "2013-01-10",
        "last_updated": "2013-02-12",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "PERRY",
        "authorized_official_middle_name": "MILTON",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "620-792-5341",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "KS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Central Kansas Family Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Great Bend, KS

Sources for this page

Verify at the official NPI Registry.