John F Line, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

15-02088 Issued in KS

Practice address

444 Four States Dr Ste 1
Galena, KS 66739-4325

Phone

(620) 783-4441

NPI assigned

Aug 29, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in OK, KS, MO3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 3

Specialty

Physician Assistant

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mercy Clinic Joplin LLCGroup PAC ID 0547300196, 288 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Specialty Hospital Southeast Kansas Hospital, Galena, KS, CCN 170203
• Saint Francis Hospital Vinita, Inc Hospital, Vinita, OK, CCN 370237
• Mercy Hospital Joplin Hospital, Joplin, MO, CCN 260001
• Integris Grove Hospital Hospital, Grove, OK, CCN 370113

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jline1317722@directc.mercy.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mercy Clinic Joplin LLC

  • Family Medicine Physician
  • Columbus, KS
  • NPI 1043547474
  Medicare reassignment Care Compare group NPD
• In Home 2 Heal LLC

  • General Practice Physician
  • Afton, OK
  • NPI 1649083031
  Medicare reassignment
• Mercy Clinic Joplin LLC

  • Family Medicine Physician
  • Joplin, MO
  • NPI 1215264817

  OK

  Medicare reassignment
• Osu Health System Anesthesia

  • Anesthesiology Physician
  • Columbus, OH
  • NPI 1174581185
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mercy Specialty Hospital Southeast Kansas

  • Special Hospital
  • Galena, KS
  • NPI 1992341473
  Care Compare affiliation
• Integris Grove Hospital

  • General Acute Care Hospital
  • Grove, OK
  • NPI 1467473579
  Care Compare affiliation
• Integris Grove Hospital

  • Ambulance
  • Grove, OK
  • NPI 1770626608

  Hospital

  Care Compare affiliation
• Mercy Hospital Joplin

  • General Acute Care Hospital
  • Joplin, MO
  • NPI 1700112745
  Care Compare affiliation
• Saint Francis Hospital Vinita, Inc

  • Medicare Defined Swing Bed Hospital Unit
  • Vinita, OK
  • NPI 1467902460
  Care Compare affiliation
• Saint Francis Hospital Vinita, Inc

  • Psychiatric Hospital Unit
  • Vinita, OK
  • NPI 1578013579
  Care Compare affiliation
• Saint Francis Hospital Vinita, Inc

  • General Acute Care Hospital
  • Vinita, OK
  • NPI 1700334232
  Care Compare affiliation

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

{
    "created_epoch": "1125273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669766400000",
    "number": "1982697553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 FOUR STATES DR STE 1",
            "city": "GALENA",
            "state": "KS",
            "postal_code": "667394325",
            "telephone_number": "620-783-4441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 FOUR STATES DR STE 1",
            "city": "GALENA",
            "state": "KS",
            "postal_code": "667394325",
            "telephone_number": "620-783-4441"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4140 SE Adams Rd",
            "address_2": "Ste 102",
            "address_purpose": "LOCATION",
            "city": "Bartlesville",
            "state": "OK",
            "postal_code": "74006",
            "country_code": "US",
            "telephone_number": "918-331-1653",
            "fax_number": "918-331-1645",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8803 S 101st East Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741337546",
            "country_code": "US",
            "telephone_number": "918-574-0220",
            "fax_number": "918-574-0229",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LINE",
        "first_name": "JOHN",
        "middle_name": "F",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-29",
        "last_updated": "2022-11-30",
        "certification_date": "2022-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "804",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "PA804",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KS",
            "license": "15-02088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeremy Jones, RN
• Alisha N Kelly, MS, CCC-SLP
• Kinex Medical Company, LLC
• Kurtis William Krtek, PT
• Kevin Hal Liljenquist
• Sydnee Maffei, PTA
• Keith Allen Mallatt, O.D.
• Katie L Marsh, PA
• Mark Steven Mayberry Jr., PHARMD
• Brent Wayne McBrien, PTA

• Physician Assistant in Galena, KS
• Providers in Galena, KS by specialty
• Physician Assistant in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.