Coffey County Medical Center

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

COFFEY COUNTY MEDICAL CENTER

Practice address

321 Atherly
Gridley, KS 66852

Phone

(620) 836-2915

Fax

(620) 836-2917

NPI assigned

Jun 16, 2005

Organization subpart

No

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

Authorized official

Name

Deanna Wolken

Title

Clinic Administrator

Phone

(620) 364-5395

Specialties & licenses 1

Addresses

Other names 1

• Gridley Medical Clinic Doing business as

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

CLIA laboratory certificates

Tax ID family

Scott a Franksen4 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.

• Coffey County Medical Center

  • Family Medicine Physician
  • Waverly, KS
  • NPI 1013912088
  NPD tax ID
• Coffey County Medical Center

  • Clinic/Center
  • Yates Center, KS
  • NPI 1356345888
  NPD tax ID
• Coffey County Medical Center

  • Family Medicine Physician
  • Leroy, KS
  • NPI 1548264195
  NPD tax ID

Practitioners 1

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

• Laurel Louderbaugh, RN, MN, ARNP-C

  • Nurse Practitioner
  • Iola, KS
  • NPI 1891724571
  NPD (past)

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1922003995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 289",
            "city": "BURLINGTON",
            "state": "KS",
            "postal_code": "668390289",
            "telephone_number": "620-364-5395",
            "fax_number": "620-364-8719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 ATHERLY",
            "city": "GRIDLEY",
            "state": "KS",
            "postal_code": "66852",
            "telephone_number": "620-836-2915",
            "fax_number": "620-836-2917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COFFEY COUNTY MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-16",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "WOLKEN",
        "authorized_official_first_name": "DEANNA",
        "authorized_official_title_or_position": "CLINIC ADMINISTRATOR",
        "authorized_official_telephone_number": "620-364-5395"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "KS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gridley Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.