NPIMap

Organization Active NPI

South Central Kansas Regional Medical Center

  • Rural Health Clinic/Center
  • Arkansas City, KS
National Provider Identifier
1962947952
Registry record updated Oct 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
SOUTH CENTRAL KANSAS REGIONAL MEDICAL CENTER
Practice address
6401 Patterson Pkwy
Arkansas City, KS 67005-5701
Phone
(620) 442-2100
NPI assigned
Dec 29, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2025

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

Authorized official

Name
Shannon Gray
Title
Cfo
Phone
(620) 441-5910

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

6401 Patterson Pkwy
Arkansas City, KS 67005-5701

Mailing address

6401 Patterson Pkwy
Arkansas City, KS 67005-5701
Phone (620) 442-2100

Other names 1

  • SCK Health Rural Health Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040209000555 KS Part B Supplier - Clinic/Group Practice 1456245802 Receives reassigned benefits from 44 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Arkansas City, KS
O20180129000381 KS Part A Provider - Rural Health Clinic 1456245802 Practice locations: Arkansas City, KS

Rural health clinic certification: CCN 178609

Legal name
SOUTH CENTRAL KANSAS REGIONAL MEDICAL CENTER
Doing business as
SCK HEALTH RURAL HEALTH CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Nov 9, 2009
Last certification
Sep 21, 2009
Ownership / control type
2B
Most recent change of ownership
Oct 1, 2017 (1 total)
Organization structure
OtherNon-profit
Enrollment address
6401 Patterson Pkwy
Arkansas City, KS 67005-5701
Related CCNs
170150

Other NPIs with the same Medicare PAC ID 4

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

Other NPIs on the same Medicare enrollment 6

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

National Provider Directory

National Provider Directory
Tax ID family
Arkansas City Emer7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Locations

515 N Summit St
Arkansas City, KS 67005
Phone (620) 442-4850

Ownership & related parties

All disclosed owners & managing parties 6

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Brad Bryant Individual Corporate DirectorSecretary Feb 20, 2024
Rodger Maechtlen Individual Corporate DirectorChairman Apr 2, 2024
Jay Warren Individual Corporate Director May 24, 2018
Shannon Gray Individual Corporate OfficerCfo Jan 2, 2024
Corporate DirectorCfo Jan 2, 2024
W-2 Managing EmployeeCfo Jan 2, 2024
Chad Beeson Individual Corporate Director Jan 4, 2024
Margaret Grismer Individual Corporate OfficerCeo Feb 7, 2025
W-2 Managing EmployeeAd; Feb 7, 2025

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
South Central Kansas Regional Medical CenterArkansas City, KS, CCN 17U150 Hospital Operational/Managerial Control (100%) Mar 17, 2011

Owned or controlled facilities with NPI records 1

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

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": "1482969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761696000000",
    "number": "1962947952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6401 PATTERSON PKWY",
            "city": "ARKANSAS CITY",
            "state": "KS",
            "postal_code": "670055701",
            "telephone_number": "620-442-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6401 PATTERSON PKWY",
            "city": "ARKANSAS CITY",
            "state": "KS",
            "postal_code": "670055701",
            "telephone_number": "620-442-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH CENTRAL KANSAS REGIONAL MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-29",
        "last_updated": "2025-10-29",
        "certification_date": "2025-10-29",
        "status": "A",
        "authorized_official_last_name": "GRAY",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "620-441-5910"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SCK Health Rural Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Arkansas City, KS

Sources for this page

Verify at the official NPI Registry.