NPIMap

Organization Active NPI

Jefferson County Memorial Hospital, Inc

  • Multi-Specialty Clinic/Center
  • Basehor, KS
National Provider Identifier
1871969865
Registry record updated Mar 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
License
H044001 Issued in KS
Legal business name
JEFFERSON COUNTY MEMORIAL HOSPITAL, INC
Practice address
15630 Pinehurst Dr
Suite 5
Basehor, KS 66007-8233
Phone
(913) 774-4340
Fax
(913) 774-3379
NPI assigned
Aug 13, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2023

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

Authorized official

Name
Jason Johnson
Title
Cfo
Phone
(913) 933-4020

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X H044001 KS Primary

Addresses

Primary practice location

15630 Pinehurst Dr
Suite 5
Basehor, KS 66007-8233

Mailing address

408 Delaware St
Winchester, KS 66097-4003
Phone (913) 774-4340

Other identifiers 2

IdentifierTypeStateIssuer
100080370FMedicaidKS
110046OtherKSMEDICARE ID TYPE UNSPECIFIED

Other names 1

  • FW Huston Family Medicine Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050215000085 KS Part B Supplier - Clinic/Group Practice 6002868445 Receives reassigned benefits from 10 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Winchester, KS; Basehor, KS

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Jefferson Co Mem Hosp Inc8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1439424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679875200000",
    "number": "1871969865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 DELAWARE ST",
            "city": "WINCHESTER",
            "state": "KS",
            "postal_code": "660974003",
            "telephone_number": "913-774-4340",
            "fax_number": "913-774-3379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15630 PINEHURST DR",
            "address_2": "SUITE 5",
            "city": "BASEHOR",
            "state": "KS",
            "postal_code": "660078233",
            "telephone_number": "913-774-4340",
            "fax_number": "913-774-3379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFERSON COUNTY MEMORIAL HOSPITAL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-13",
        "last_updated": "2023-03-27",
        "certification_date": "2023-03-27",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "913-933-4020"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "KS",
            "license": "H044001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100080370F",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID TYPE UNSPECIFIED",
            "identifier": "110046",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FW Huston Family Medicine",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "FW Huston Family Medicine",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Basehor, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.