SUSAN B. ALLEN MEMORIAL HOSPITAL (NPI# 1124594957) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124594957 |
| Entity Type | Organization |
| Organization Name | SUSAN B. ALLEN MEMORIAL HOSPITAL |
| Practice Address |
700 W Central Ave Ste 103 El Dorado KS 67042-2187 |
| Mailing Address |
720 W Central Ave El Dorado KS 67042-2112 |
| Practice Telephone | 3163218751 |
| Enumeration Date | 2018-10-19 |
| Last Update Date | 2018-10-19 |
| Authorized Official Name | MR. MARK ROOKER (CIO/COO) |
| Authorized Official Telephone | 3163224518 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207PE0004X |
Emergency Medicine Specialization: Emergency Medical Services |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| SBA Medical Group | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588156574 | Susan B. Allen Memorial Hospital | Clinic/Center | 2710 W Central Ave, El Dorado, KS 67042-3285 | 2018-06-05 |
| 1003338914 | Susan B. Allen Memorial Hospital | Preventive Medicine | 720 W Central Ave Ste 111, El Dorado, KS 67042-2112 | 2017-07-12 |
| 1457766800 | Susan B. Allen Memorial Hospital | Family Medicine | 401 W 7th Ave, Augusta, KS 67010-1309 | 2014-06-24 |
| 1922431329 | Susan B. Allen Memorial Hospital | Orthopaedic Surgery | 700 W Central Ave Ste 108, El Dorado, KS 67042-2187 | 2013-08-21 |
| 1356783286 | Susan B. Allen Memorial Hospital | Otolaryngology | 700 W Central Ave Ste 202, El Dorado, KS 67042-2186 | 2013-07-19 |
| 1285870618 | Susan B. Allen Memorial Hospital | Family Medicine | 700 W Central Ave Ste 204, El Dorado, KS 67042-2186 | 2009-01-07 |
| 1700994977 | Susan B. Allen Memorial Hospital | Pharmacy | 720 W. Central Ave, El Dorado, KS 67042-2144 | 2006-08-28 |
| 1144724667 | Susan B. Allen Memorial Hospital | Audiologist | 700 W Central Ave Ste 202, El Dorado, KS 67042-2186 | 2018-03-20 |
| 1104349067 | Susan B. Allen Memorial Hospital | Hospitalist | 720 W Central Ave, El Dorado, KS 67042-2112 | 2017-07-24 |
| 1922520832 | Susan B. Allen Memorial Hospital | Family Medicine | 401 W 7th Ave, Augusta, KS 67010-1309 | 2017-07-12 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | SUSAN B. ALLEN MEMORIAL HOSPITAL, THE | 720 W Central Ave, El Dorado, KS 67042-2112 |
| Street Address |
700 W CENTRAL AVE STE 103 |
| City | EL DORADO |
| State | KS |
| Zip Code | 67042-2187 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821526104 | Nolan Ryan Andrews | Dentist | 535 S. Main Street, El Dorado, KS 67042 | 2017-05-31 |
| 1902262355 | Lisbeth Leiber | Nurse Practitioner | 1737 Se Hwy 54, El Dorado, KS 67042 | 2016-01-14 |
| 1992180202 | Jennifer Clausing | Pharmacist | 205 N. Vine, El Dorado, KS 67042 | 2015-07-28 |
| 1053706655 | Aubrey Shea Ralston | General Practice | 700 W Central Ave Ste 205, El Dorado, KS 67042 | 2015-03-31 |
| 1316341027 | William L Wade | Nurse Practitioner | 1737 Se Highway 54, Eldorado, KS 67042 | 2014-10-09 |
| 1205070612 | Gabriel Omar De La Garza | Otolaryngology | 700 W Central Ave Suite 200, Eldorado, KS 67042 | 2009-04-29 |
| 1962608893 | South Central Mental Health Counseling Center Inc | Social Worker | 120 S Gordy, 3, El Dorado, KS 67042 | 2007-06-26 |
| 1699987958 | Grene Vision Group LLC | Ophthalmology | 1400 W Central, El Dorado, KS 67042 | 2007-05-07 |
| 1548388598 | Richard Alan Burton | Dentist | 310 Oil Hill Road, El Dorado, KS 67042 | 2007-03-27 |
| 1710002472 | Tender Care Pediatrics Pa | Pediatrics | 700 W. Central Ave, Ste 210, El Dorado, KS 67042 | 2007-03-20 |
| Find all providers in zip 67042 | ||||
| Taxonomy Code | 207PE0004X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| Specialization | Emergency Medical Services |
| An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295754075 | Roderick Rene Boyd | Emergency Medicine | 460 W Oak St Ste 601, El Dorado, AR 71730-4538 | 2006-07-19 |
| 1104844836 | Geoffrey M Vincent | Emergency Medicine | 720 W Central Ave, El Dorado, KS 67042-2112 | 2006-07-18 |
| 1184650343 | Acute Care, Inc | Emergency Medicine | 720 W Central Ave, El Dorado, KS 67042-2112 | 2006-06-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306301429 | Rikkie Renee Thouvenell | Emergency Medicine | 906 S Lincoln Ave, Chanute, KS 66720-3041 | 2019-02-02 |
| 1609185958 | Barbara K Lomeli | Emergency Medicine | 14500 S Quivira Rd, Olathe, KS 66062-9479 | 2010-10-05 |
| 1124086384 | Daniel W Doherty | Emergency Medicine | 315 W 15th Street, Liberal, KS 67905-1340 | 2006-05-03 |
| 1104815265 | Phillips County | Emergency Medicine | 409 E St, Box 309, Phillipsburg, KS 67661-1656 | 2005-10-20 |
| 1912530890 | Edward King | Emergency Medicine | 1428 S Main St Ste 4, Ottawa, KS 66067-3547 | 2020-02-19 |
| 1851867709 | Johnny Huy Nguyen | Emergency Medicine | 929 N Saint Francis St, Wichita, KS 67214-3821 | 2018-10-18 |
| 1912362682 | Newman Medical Partners LLC | Emergency Medicine | 2720 W 15th Ave, Emporia, KS 66801 | 2015-12-23 |
| 1730494048 | Kansas Physicians Group, LLC | Emergency Medicine | 2610 N Woodlawn Blvd, Wichita, KS 67220-2729 | 2010-08-11 |
| 1700106168 | Joshua David Korosac | Emergency Medicine | 325 Maine St, Lawrence, KS 66044-1360 | 2010-06-08 |
| 1003146671 | Kstar Emergency Physicians, Pllc | Emergency Medicine | 1700 Sw 7th St, Topeka, KS 66606-2489 | 2010-01-05 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.