NPIMap

Organization Active NPI

Integris Bass Baptist Health Center

Doing business as INTEGRIS Caldwell Family Clinic

  • Family Medicine Physician
  • Caldwell, KS
National Provider Identifier
1942201397
Registry record updated Mar 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
INTEGRIS BASS BAPTIST HEALTH CENTER
Doing business as
INTEGRIS Caldwell Family Clinic
Practice address
415 S Osage St
Caldwell, KS 67022-1650
Phone
(620) 845-2516
NPI assigned
Aug 9, 2005
Last updated
Mar 29, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2022

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

Authorized official

Name
Chris Hammes
Title
Senior Vice President & Coo
Phone
(405) 949-3402

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

415 S Osage St
Caldwell, KS 67022-1650

Mailing address

5400 N Independence Ave Ste 200
Oklahoma City, OK 73112-5300
Phone (405) 713-5515

Other names 1

  • INTEGRIS Caldwell Family Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031103000717 OK Part B Supplier - Clinic/Group Practice 0345151981 Receives reassigned benefits from 28 practitioners
17 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Medford, OK; Hennessey, OK; Enid, OK

Other NPIs on the same Medicare enrollment 17

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

View all 17

National Provider Directory

National Provider Directory

Ownership & related parties

Change-of-ownership history 1

DateEventCounterparty
Jul 1, 2022 Change of OwnershipThis provider was the seller Caldwell Family ClinicCCN 178644, KS, NPI 1881327153

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

NPI Registry JSON

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648512000000",
    "number": "1942201397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5400 N INDEPENDENCE AVE STE 200",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731125300",
            "telephone_number": "405-713-5515",
            "fax_number": "405-713-5532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 S OSAGE ST",
            "city": "CALDWELL",
            "state": "KS",
            "postal_code": "670221650",
            "telephone_number": "620-845-2516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRIS BASS BAPTIST HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-09",
        "last_updated": "2022-03-29",
        "certification_date": "2022-03-29",
        "status": "A",
        "authorized_official_last_name": "HAMMES",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT & COO",
        "authorized_official_telephone_number": "405-949-3402"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "INTEGRIS Caldwell Family Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Caldwell, KS

Sources for this page

Verify at the official NPI Registry.