NPIMap

Organization Active NPI

Satanta District Hospital and Long-Term Care

Doing business as Haskell County Health Department

  • Public Health or Welfare Agency
  • Sublette, KS
National Provider Identifier
1871546259
Registry record updated Aug 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
License
14267 Issued in KS
Legal business name
SATANTA DISTRICT HOSPITAL AND LONG-TERM CARE
Doing business as
Haskell County Health Department
Practice address
301 S. Derby
Sublette, KS 67877-0398
Phone
(620) 675-8191
Fax
(620) 675-2236
NPI assigned
May 18, 2006
Last updated
Aug 29, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
SATANTA DISTRICT HOSPITAL AND LONG-TERM CAREAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 29, 2025

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

Authorized official

Name
Tina Pendergraft
Title
Administrator
Phone
(620) 649-2761

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X 14267 KS Primary

Addresses

Primary practice location

301 S. Derby
Sublette, KS 67877-0398

Mailing address

PO Box 159
Satanta, KS 67870-0159
Phone (620) 649-2761

Other identifiers 3

IdentifierTypeStateIssuer
100080490DMedicaidKS
119954OtherKSBLUE CROSS
17D0882657OtherKSCLIA #

Other names 1

  • Haskell County Health Department Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151228001210 KS Part B Supplier - Mass Immunization (Roster Biller Only) 5991616054 Practice locations: Sublette, KS

Other NPIs with the same Medicare PAC ID 6

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
17D0882657Haskell County Health Department301 South Derby Street, Sublette, KS 67877Certificate of waiverAug 28, 2026

National Provider Directory

National Provider Directory
Part of
Satanta Hosp Long Term Care

Locations

309 Morton St
Elkhart, KS 67950
Phone (620) 649-2761

410 Cheyenne
#9
Satanta, KS 67870

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Satanta District HospitalSatanta, KS, CCN 171324 Hospital Operational/Managerial Control Dec 15, 1983
Satanta District Hospital Clinic SatantaSatanta, KS, CCN 173455 Rural health clinic Operational/Managerial Control Feb 10, 2015
Satanta District Hospital Clinic-SubletteSublette, KS, CCN 173454 Rural health clinic Operational/Managerial Control (100%) Aug 23, 2007

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 4

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": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756425600000",
    "number": "1871546259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 159",
            "city": "SATANTA",
            "state": "KS",
            "postal_code": "678700159",
            "telephone_number": "620-649-2761",
            "fax_number": "620-649-2776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 S. DERBY",
            "city": "SUBLETTE",
            "state": "KS",
            "postal_code": "678770398",
            "telephone_number": "620-675-8191",
            "fax_number": "620-675-2236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SATANTA DISTRICT HOSPITAL AND LONG-TERM CARE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SATANTA DISTRICT HOSPITAL AND LONG-TERM CARE",
        "enumeration_date": "2006-05-18",
        "last_updated": "2025-08-29",
        "certification_date": "2025-08-29",
        "status": "A",
        "authorized_official_last_name": "PENDERGRAFT",
        "authorized_official_first_name": "TINA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "620-649-2761"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "KS",
            "license": "14267",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100080490D",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "119954",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA #",
            "identifier": "17D0882657",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Haskell County Health Department",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sublette, KS

Sources for this page

Verify at the official NPI Registry.