COFFEYVILLE REGIONAL MEDICAL CENTER, INC. (NPI# 1629579941) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629579941 |
| Entity Type | Organization |
| Organization Name | COFFEYVILLE REGIONAL MEDICAL CENTER, INC. |
| Other Organization Name | COFFEYVILLE REGIONAL MEDICAL SWING BED |
| Practice Address |
1400 W 4th St Coffeyville KS 67337-3306 |
| Practice Telephone | 6202511200 |
| Enumeration Date | 2018-02-22 |
| Last Update Date | 2020-07-21 |
| Authorized Official Name | BRIAN LAWRENCE (CEO) |
| Authorized Official Telephone | 6202521519 |
| Authorized Official Credential | RN, MSN |
| Is Organization Subpart | Y |
| Parent Organization Name | COFFEYVILLE REGIONAL MEDICAL CENTER, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 275N00000X | Medicare Defined Swing Bed Unit | Hospital Units |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KS | 100107200B | 05 |
| Other Name | Type Code |
|---|---|
| Coffeyville Regional Medical Swing Bed | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295284842 | Coffeyville Regional Medical Center, Inc. | Clinic/Center | 122 W Myrtle St Lowr Level, Independence, KS 67301-3317 | 2016-09-23 |
| 1285600379 | Coffeyville Regional Medical Center, Inc. | General Acute Care Hospital | 1400 W 4th Street, Coffeyville, KS 67337 | 2006-02-27 |
| 1699851725 | Coffeyville Regional Medical Center, Inc. | Psychiatric Unit | 1400 W 4th St, Coffeyville, KS 67337-3306 | 2006-10-31 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | COFFEYVILLE REGIONAL MEDICAL CENTER, INC. | 1400 W 4th St, Coffeyville, KS 67337-3306 |
| Oklahoma Business Registrations | COFFEYVILLE REGIONAL MEDICAL CENTER, INC. | 1400 W 4th St, Coffeyville, KS 67337 |
| Street Address |
1400 W 4TH ST |
| City | COFFEYVILLE |
| State | KS |
| Zip Code | 67337-3306 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073510764 | Mary Beth Hartley | Nurse Practitioner | 1400 W 4th St, Coffeyville, KS 67337-3306 | 2005-07-07 |
| 1902403801 | Bridget Catherine Eloise Vargas | Nurse Practitioner | 1400 W 4th St, Coffeyville, KS 67337-3306 | 2020-10-04 |
| 1982229266 | Allison Nichole Littleford | Nurse Practitioner | 1400 W 4th St, Coffeyville, KS 67337-3306 | 2020-06-11 |
| 1144794843 | Chad Young Mccready | Physician Assistant | 1400 W 4th St, Coffeyville, KS 67337-3306 | 2019-01-15 |
| 1205340445 | Julia Dawn Moses | Nurse Anesthetist, Certified Registered | 1400 W 4th St, Coffeyville, KS 67337-3306 | 2017-11-27 |
| 1700302304 | Judy Ann Carpenter | Nurse Practitioner | 1400 W 4th St, Coffeyville, KS 67337-3306 | 2017-08-16 |
| 1932629300 | Brock James Juffs | Family Medicine | 1400 W 4th St, Coffeyville, KS 67337-3306 | 2017-06-26 |
| 1639607781 | Heather Lee Pollet | Registered Nurse | 1400 W 4th St, Coffeyville, KS 67337-3306 | 2017-06-01 |
| 1740714575 | Peer Medical Imaging Interpretation LLC | Radiology | 1400 W 4th St, Coffeyville, KS 67337-3306 | 2017-04-19 |
| 1053862805 | Coffeyville Regional Medical Center Inc | Clinic/Center | 1400 W 4th St, Ste 100, Coffeyville, KS 67337-3306 | 2016-10-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245858471 | Colby Robert Andreasen-cannon | Pharmacist | 1863 5300 Rd, Coffeyville, KS 67337 | 2020-07-14 |
| 1558917245 | Zachary James Newman | Case Manager/Care Coordinator | 1601 West 4th Street, Coffeyville, KS 67337 | 2019-08-18 |
| 1669725396 | Traeger Nelson Tvedten | Chiropractor | 411 1/2 West 11th Street, Coffeyville, KS 67337 | 2012-10-18 |
| 1831408020 | Carrie Lane Strimple | Family Medicine | 1505 W 11th St Ste C, Coffeyville, KS 67337 | 2010-10-05 |
| 1093047185 | Terry D Powell Radiation Oncologist, Inc. | Radiology | 1400 W 4th St, Radiation Oncology Dept, Coffeyville, KS 67337 | 2010-02-01 |
| 1649446931 | Windsor Place At Home Care LLC | Technician | 415 W 11th, Coffeyville, KS 67337 | 2008-05-06 |
| 1679668115 | Daniel H Chappell | Obstetrics & Gynecology | 801 W 8th St., Coffeyville, KS 67337 | 2006-10-03 |
| 1760582878 | Jack S Bell | Physician Assistant | 1411 W 4th, Suite G, Coffeyville, KS 67337 | 2006-09-25 |
| 1114026937 | Stephen A Miller | Obstetrics & Gynecology | 1717 West Eighth, Coffeyville, KS 67337 | 2006-09-21 |
| 1285600379 | Coffeyville Regional Medical Center, Inc. | General Acute Care Hospital | 1400 W 4th Street, Coffeyville, KS 67337 | 2006-02-27 |
| Find all providers in zip 67337 | ||||
| Taxonomy Code | 275N00000X |
| Grouping | Hospital Units |
| Classification | Medicare Defined Swing Bed Unit |
| A unit of a hospital that has a Medicare provider agreement and has been granted approval from HCFA to provide post-hospital extended care services and be reimbursed as a swing-bed unit. |
| Notes: Source: Code of Federal Regulations #42, Section 482.66. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801976857 | Meade Hospital District | Medicare Defined Swing Bed Unit | 510 East Carthage, Meade, KS 67864-0820 | 2006-10-16 |
| 1487749602 | Great Plains of Ellinwood, Inc. | Medicare Defined Swing Bed Unit | 605 North Main, Ellinwood, KS 67526 | 2006-10-04 |
| 1952495939 | Citizens Medical Center, Inc | Medicare Defined Swing Bed Unit | 100 East College Drive, Colby, KS 67701-3799 | 2006-10-03 |
| 1235231697 | Hamilton County Hospital | Medicare Defined Swing Bed Unit | 700 N. Huser, Syracuse, KS 67878-0948 | 2006-09-05 |
| 1346342771 | Mcpherson Hospital, Inc. | Medicare Defined Swing Bed Unit | 1000 Hospital Drive, Mcpherson, KS 67460 | 2006-09-05 |
| 1285640912 | Mercy Hospital Inc | Medicare Defined Swing Bed Unit | 218 E. Pack Street, Moundridge, KS 67107-0180 | 2006-08-01 |
| 1063489219 | Stevens County Hospital | Medicare Defined Swing Bed Unit | 1006 Jackson Street, Hugoton, KS 67951 | 2006-03-07 |
| 1659348589 | Community Memorial Healthcare, Inc. | Medicare Defined Swing Bed Unit | 708 N 18th St, Marysville, KS 66508-1338 | 2006-02-28 |
| 1316937428 | Wichita County Health Center | Medicare Defined Swing Bed Unit | 211 East Earl, Leoti, KS 67861-9802 | 2005-10-28 |
| 1679572721 | Ascension Via Christi Hospital Manhattan, Inc. | Medicare Defined Swing Bed Unit | 1823 College Ave., Manhattan, KS 66502-3381 | 2005-07-20 |
| Find all providers with the same taxonomy | ||||
| City | COFFEYVILLE |
| Zip Code | 67337 |
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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.