NPIMap

Organization Active NPI

Prime Healthcare Services - Saint John Leavenworth LLC

  • Rural Health Clinic/Center
  • Leavenworth, KS
National Provider Identifier
1912875600
Registry record updated Oct 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
PRIME HEALTHCARE SERVICES - SAINT JOHN LEAVENWORTH LLC
Practice address
3550 S 4TH St Ste 200
Leavenworth, KS 66048-5009
Phone
(913) 680-6442
Fax
(913) 680-6425
NPI assigned
Oct 25, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2025

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

Authorized official

Name
Christopher Doan
Title
Managing Associate General Counsel
Phone
(310) 259-4706

Specialties & licenses 1

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

Addresses

Primary practice location

3550 S 4TH St Ste 200
Leavenworth, KS 66048-5009

Mailing address

3550 S 4TH St Ste 200
Leavenworth, KS 66048-5009
Phone (913) 680-6442

Other names 1

  • Saint John Primary Care Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Prime Healthcare Services - Saint John Leavenworth LLC8 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.

Locations

3550 S 4th St
Ste 200
Leavenworth, KS 66048
Phone (913) 680-6442

NPI Registry JSON

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

{
    "created_epoch": "1761350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761350400000",
    "number": "1912875600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3550 S 4TH ST STE 200",
            "city": "LEAVENWORTH",
            "state": "KS",
            "postal_code": "660485009",
            "telephone_number": "913-680-6442",
            "fax_number": "913-680-6425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3550 S 4TH ST STE 200",
            "city": "LEAVENWORTH",
            "state": "KS",
            "postal_code": "660485009",
            "telephone_number": "913-680-6442",
            "fax_number": "913-680-6425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME HEALTHCARE SERVICES - SAINT JOHN LEAVENWORTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-25",
        "last_updated": "2025-10-25",
        "certification_date": "2025-10-25",
        "status": "A",
        "authorized_official_last_name": "DOAN",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "MANAGING ASSOCIATE GENERAL COUNSEL",
        "authorized_official_telephone_number": "310-259-4706"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Saint John Primary Care Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Leavenworth, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2025; 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.