NPIMap

Organization Active NPI

The Family Physicians PA

Doing business as Family Physicians P A

  • Rural Health Clinic/Center
  • Iola, KS
National Provider Identifier
1851325773
Registry record updated Oct 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
178969 Issued in KS
Legal business name
THE FAMILY PHYSICIANS PA
Doing business as
Family Physicians P A
Practice address
1408 East St
Iola, KS 66749-4402
Phone
(620) 365-3115
Fax
(620) 365-7717
NPI assigned
Jul 10, 2006
Last updated
Oct 4, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2024

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

Authorized official

Name
Martha Elaine O'Connor
Title
Administrator
Phone
(620) 365-3115

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X 178969 KS Primary

Addresses

Primary practice location

1408 East St
Iola, KS 66749-4402

Mailing address

1408 East Street
Iola, KS 66749-3004
Phone (620) 365-3115

Other identifiers 4

IdentifierTypeStateIssuer
1550OtherKSBLUE CROSS RHC
178969OtherKSRURAL HEALTH IDENTIFICATION
100215590BMedicaidKS
17D0450573OtherCLIA WAIVER

Other names 1

  • Family Physicians P A Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20030430000031 KS Part A Provider - Rural Health Clinic 9436069267 Practice locations: Iola, KS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1851325773. Details of each certification follow.

Rural health clinic certification: CCN 178969

Legal name
THE FAMILY PHYSICIANS PA
Doing business as
FAMILY PHYSICIANS P A
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Sep 3, 2003
Last certification
Sep 23, 2009
Ownership / control type
1B
Organization structure
CorporationProprietary
Incorporated
Dec 14, 1992 in KS
Enrollment address
1408 East Street
Iola, KS 66749-4002

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Family Physicians4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 4

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Martha Elaine O'Connor Individual Contracted Managing EmployeeAdministrator Jan 1, 2021
Corporate Director Jan 1, 2022
W-2 Managing EmployeeAdministrator Jan 1, 2022
Rebecca L Watson Individual Corporate OfficerSec./Treas. Nov 18, 2013
Timothy C Spears Individual 5% Or Greater Direct Ownership Interest33.33 Nov 18, 2013
Corporate OfficerVice President Nov 18, 2013 33.33%
Frank O Porter Individual 5% Or Greater Direct Ownership Interest Nov 18, 2013 33.33%
General Partnership Interest Aug 18, 2013
Corporate OfficerPresident Nov 18, 2013 33.33%

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728000000000",
    "number": "1851325773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1408 EAST STREET",
            "city": "IOLA",
            "state": "KS",
            "postal_code": "667493004",
            "telephone_number": "620-365-3115",
            "fax_number": "620-365-7717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1408 EAST ST",
            "city": "IOLA",
            "state": "KS",
            "postal_code": "667494402",
            "telephone_number": "620-365-3115",
            "fax_number": "620-365-7717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE FAMILY PHYSICIANS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-10",
        "last_updated": "2024-10-04",
        "certification_date": "2024-10-04",
        "status": "A",
        "authorized_official_last_name": "O'CONNOR",
        "authorized_official_first_name": "MARTHA",
        "authorized_official_middle_name": "ELAINE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "620-365-3115"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "KS",
            "license": "178969",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS RHC",
            "identifier": "1550",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RURAL HEALTH IDENTIFICATION",
            "identifier": "178969",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100215590B",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA WAIVER",
            "identifier": "17D0450573",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Physicians P A",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Iola, KS

Sources for this page

Verify at the official NPI Registry.