COFFEYVILLE REGIONAL MEDICAL CENTER, INC. (NPI# 1699851725) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699851725 |
| Entity Type | Organization |
| Organization Name | COFFEYVILLE REGIONAL MEDICAL CENTER, INC. |
| Other Organization Name | COFFEYVILLE REGIONAL MEDICAL CENTER, INC. |
| Practice Address |
1400 W 4th St Coffeyville KS 67337-3306 |
| Practice Telephone | 6202521649 |
| Practice Fax Number | 6202521699 |
| Mailing Telephone | 6202521649 |
| Mailing Fax Number | 6202521699 |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2007-07-08 |
| Authorized Official Name | JERRY MARQUETTE (CEO) |
| Authorized Official Telephone | 6202521537 |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 273R00000X | Psychiatric Unit | H063002 | KS | Hospital Units |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KS | KS FACILITY LICENSE # | H063002 | 01 |
| Other Name | Type Code |
|---|---|
| Coffeyville Regional Medical Center, Inc. | Other Name - Individual/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 |
| 1629579941 | Coffeyville Regional Medical Center, Inc. | Medicare Defined Swing Bed Unit | 1400 W 4th St, Coffeyville, KS 67337-3306 | 2018-02-22 |
| 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 |
| 1629579941 | Coffeyville Regional Medical Center, Inc. | Medicare Defined Swing Bed Unit | 1400 W 4th St, Coffeyville, KS 67337-3306 | 2018-02-22 |
| 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 |
| 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 | 273R00000X |
| Grouping | Hospital Units |
| Classification | Psychiatric Unit |
| In general, a distinct unit of a hospital that provides acute or long-term care to emotionally disturbed patients, including patients admitted for diagnosis and those admitted for treatment of psychiatric problems on the basis of physicians' orders and approved nursing care plans. Long-term care may include intensive supervision to the chronically mentally ill, mentally disordered or other mentally incompetent persons; (2) For Medicare, a distinct part of a general acute care hospital admitting only patients whose admission to the unit is required for active treatment, whose treatment is of an intensity that can be provided only in an inpatient hospital setting, and whose condition is described by a psychiatric principal diagnosis contained in the Third Edition of the American Psychiatric Association Diagnostic and Statistical Manual or in Chapter 5 (Mental Disorders) of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). The unit must furnish, through the use of qualified personnel, psychological services, social work services, psychiatric nursing, occupational therapy, and recreational therapy. The unit must maintain medical records that permit determination of the degree and intensity of treatment provided to individuals who are furnished services in the unit; the unit must meet special staff requirements in that the unit must have adequate numbers of qualified professional and supportive staff to evaluate inpatients, formulate written, individualized, comprehensive treatment plans, provide active treatment measures and engage in discharge planning. |
| Notes: Source: (1) AHA Annual Survey p. A10 1996 AHA Guide; (2) Code of Federal Regulations #42, Section 412.27. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417373556 | Khan Noohani Md Pa | Psychiatric Unit | 1323 North A Street, Sumner Regional Medical Center, Wellington, KS 67152 | 2014-03-13 |
| 1326147547 | Great Plains of Kiowa County, Inc. | Psychiatric Unit | 501 S Walnut St, Greensburg, KS 67054-1951 | 2006-09-22 |
| 1336148485 | Ascension Via Christi Hospital Manhattan, Inc. | Psychiatric Unit | 222 N 6th St, Manhattan, KS 66502-6057 | 2005-07-20 |
| 1700429917 | South Central Kansas Regional Medical Center | Psychiatric Unit | 6401 Patterson Pkwy, Arkansas City, KS 67005-5701 | 2019-10-21 |
| 1962971903 | Sumner Community Hospital LLC | Psychiatric Unit | 1323 N A St, Wellington, KS 67152-4350 | 2018-11-20 |
| 1316334667 | Harper Hospital | Psychiatric Unit | 700 W 13th St, Harper, KS 67058-1401 | 2015-04-23 |
| 1598108680 | Prime Healthcare Services - Saint John Leavenworth LLC | Psychiatric Unit | 3500 S 4th St, Leavenworth, KS 66048-5043 | 2013-04-09 |
| 1982993614 | Hays Medical Center, Inc. | Psychiatric Unit | 205 E 7th St, Suite 308, Hays, KS 67601-4907 | 2011-04-04 |
| 1245475946 | Hospital District No 1 Crawford County | Psychiatric Unit | 302 N Hospital Dr, Girard, KS 66743-2000 | 2008-12-09 |
| 1497955066 | Via Christi Regional Medical Center | Psychiatric Unit | 929 N Saint Francis St, Wichita, KS 67214-3821 | 2007-07-23 |
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| 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.