PRAIRIE BAND POTAWATOMI NATION (NPI# 1245266410) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245266410 |
| Entity Type | Organization |
| Organization Name | PRAIRIE BAND POTAWATOMI NATION |
| Other Organization Name | PRAIRIE BAND POTAWATOMI HEALTH CENTER |
| Practice Address |
11400 158th Rd Mayetta KS 66509-0249 |
| Practice Telephone | 7859668200 |
| Practice Fax Number | 7859668393 |
| Mailing Telephone | 7859668200 |
| Mailing Fax Number | 7859668393 |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2018-06-20 |
| Authorized Official Name | ASHLEY FOSTER (BUSINESS OFFICE MANAGER) |
| Authorized Official Telephone | 7859668200 |
| Is Organization Subpart | Y |
| Parent Organization Name | PRAIRIE BAND POTAWATOMI NATION |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QH0100X |
Clinic/Center Specialization: Health Service |
========= | KS | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KS | 200259300A | 05 |
| Other Name | Type Code |
|---|---|
| Prairie Band Potawatomi Health Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174577738 | Prairie Band Potawatomi Nation | Ambulance | 15468 K Rd, Mayetta, KS 66509-9093 | 2006-05-19 |
| 1952323958 | Prairie Band Potawatomi Nation | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 11400 158th Rd, Mayetta, KS 66509-8866 | 2006-07-25 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | PRAIRIE BAND POTAWATOMI NATION | 16281 Q Rd, Mayetta, KS 66509-8970 |
| Street Address |
11400 158TH RD |
| City | MAYETTA |
| State | KS |
| Zip Code | 66509-0249 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679060776 | Edith Wamego | Behavior Technician | 11400 158th Rd, Mayetta, KS 66509-8866 | 2018-04-16 |
| 1326499955 | Brendan Michael Handy | Pharmacist | 11400 158th Rd, Mayetta, KS 66509-8866 | 2016-06-24 |
| 1053761668 | Charles G Beals | Dentist | 11400 158th Rd, Mayetta, KS 66509 | 2016-06-14 |
| 1558760983 | Walter Anthony Siebert | Social Worker | 11400 158th Rd, Mayetta, KS 66509-8866 | 2014-08-21 |
| 1992973218 | Mary Melinda Boren | Registered Nurse | 11400 158th Rd, Mayetta, KS 66509-8866 | 2008-02-20 |
| 1346467230 | James S Bear Jr. | Family Medicine | 11400 158th Rd, Mayetta, KS 66509-8866 | 2007-04-20 |
| 1063582443 | Randy J German | Dentist | 11400 158th Rd, Mayetta, KS 66509 | 2006-11-09 |
| 1427132612 | Nola Ahlquist-turner | Nurse Practitioner | 11400 158th Rd, Mayetta, KS 66509-8866 | 2006-10-24 |
| 1952323958 | Prairie Band Potawatomi Nation | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 11400 158th Rd, Mayetta, KS 66509-8866 | 2006-07-25 |
| 1881625721 | Terry Lee Harter | Family Medicine | 11400 158th Rd, Mayetta, KS 66509-8866 | 2006-07-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508286113 | Mendy Lynn Thompson | Counselor | 11400 158th Road, Mayetta, KS 66509 | 2014-04-22 |
| 1699042010 | Cindy Kelly | Social Worker | 11400 158 Road, Mayetta, KS 66509 | 2011-11-30 |
| 1932306883 | Independent Anesthesia Services, LLC | Nurse Anesthetist, Certified Registered | 14395 Hwy 75, Mayetta, KS 66509 | 2007-07-02 |
| 1851313050 | Royal Valley Usd 337 | Local Education Agency (LEA) | 101 W Main, Mayetta, KS 66509 | 2006-07-24 |
| 1679993018 | Norman David Arnold | Counselor | 11400 158th Rd., Mayetta, KS 66509-0174 | 2014-04-24 |
| 1043630650 | Elaine Mzhickteno Barr | Counselor | 11400 - 158th Road, Mayetta, KS 66509-0174 | 2014-04-22 |
| 1093037426 | Royal Valley | Local Education Agency (LEA) | 101 W Main, Mayetta, KS 66509-0219 | 2010-02-26 |
| 1104806637 | Nancy H Noble | Family Medicine | 15419 154th Rd, Mayetta, KS 66509-8715 | 2006-01-19 |
| 1023382215 | Toby Edward Leavendusky | Registered Nurse | 16809 R Rd, Mayetta, KS 66509-8954 | 2012-03-06 |
| 1174577738 | Prairie Band Potawatomi Nation | Ambulance | 15468 K Rd, Mayetta, KS 66509-9093 | 2006-05-19 |
| Find all providers in zip 66509 | ||||
| Taxonomy Code | 261QH0100X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Health Service |
| Definition to come... |
| Notes: [7/1/2006: modified title] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184164964 | Scott T Sander, O.d., L.L.C. | Clinic/Center | 16082 Metcalf Ave, Overland Park, KS 66085-9249 | 2017-02-28 |
| 1548668312 | Manhattan Urgent Care, LLC | Clinic/Center | 16234 Metcalf Ave, Overland Park, KS 66085-9147 | 2014-12-10 |
| 1083054266 | Schabel Performance Health & Wellness LLC | Clinic/Center | 13342 Pawnee St, Leawood, KS 66209-3348 | 2013-07-02 |
| 1750643433 | Walters Chiropractic, LLC | Clinic/Center | 2011 E Crossroads Ln, Suite 302, Olathe, KS 66062-1674 | 2012-06-08 |
| 1184954257 | Rhoades Corporation | Clinic/Center | 2215 Sw Westport Dr, Topeka, KS 66614-1926 | 2010-01-12 |
| 1710136759 | Concentra Health Services, Inc. | Clinic/Center | 14809 West 95th St., Lenexa, KS 66215 | 2008-09-15 |
| 1013176221 | Christian Care Cottage | Clinic/Center | 415 S Poplar St, Ottawa, KS 66067-2438 | 2008-06-03 |
| 1306021860 | Kansas Chiropractic Clinics, LLC | Clinic/Center | 431 Timber Ridge Cir, Derby, KS 67037-3637 | 2008-01-03 |
| 1649462490 | Greenwood County Hospital | Clinic/Center | 410 Merchant Ave, Fall River, KS 67047 | 2007-08-15 |
| 1275745085 | County of Ness | Clinic/Center | 202 W Sycamore St, Ness City, KS 67560-1564 | 2007-05-04 |
| 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.