JEFFERSON COUNTY MEMORIAL HOSPITAL (NPI# 1871969865) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871969865 |
| Entity Type | Organization |
| Organization Name | JEFFERSON COUNTY MEMORIAL HOSPITAL |
| Other Organization Name | FW HUSTON FAMILY MEDICINE |
| Practice Address |
15630 Pinehurst Dr Suite 5 Basehor KS 66007-8233 |
| Mailing Address |
408 Delaware St Winchester KS 66097-4003 |
| Practice Telephone | 9137744340 |
| Practice Fax Number | 9137743379 |
| Mailing Telephone | 9137744340 |
| Mailing Fax Number | 9137743379 |
| Enumeration Date | 2015-08-13 |
| Last Update Date | 2016-02-01 |
| Authorized Official Name | MR. LA MONT COOK (CEO) |
| Authorized Official Telephone | 9137744340 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
H044001 | KS | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KS | 100080370F | 05 | |
| KS | MEDICARE ID TYPE UNSPECIFIED | 110046 | 01 |
| Other Name | Type Code |
|---|---|
| FW Huston Family Medicine | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447660360 | Jefferson County Memorial Hospital | Clinic/Center | 504 Plaza Dr, Suite 300, Perry, KS 66073-4136 | 2014-04-30 |
| 1750354908 | Jefferson County Memorial Hospital | Physician Assistant | 408 Delaware St, Winchester, KS 66097-4003 | 2006-02-08 |
| 1215459367 | Jefferson County Memorial Hospital | Psychiatry & Neurology | 412 E Walnut St, Nortonville, KS 66060-4008 | 2017-07-11 |
| 1457710790 | Jefferson County Memorial Hospital | Clinic/Center | 15630 Pinehurst Dr, Suite 5, Basehor, KS 66007-8233 | 2016-02-15 |
| 1700245057 | Jefferson County Memorial Hospital | Clinic/Center | 408 Delaware St, Winchester, KS 66097-4003 | 2016-02-15 |
| 1265739288 | Jefferson County Memorial Hospital | Clinic/Center | 409 Broadway St, Valley Falls, KS 66088-1303 | 2011-02-28 |
| Street Address |
15630 PINEHURST DR SUITE 5 |
| City | BASEHOR |
| State | KS |
| Zip Code | 66007-8233 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972065431 | Alison L Skelton | Occupational Therapist | 15630 Pinehurst Dr, Ste 1, Basehor, KS 66007-8238 | 2019-04-03 |
| 1457710790 | Jefferson County Memorial Hospital | Clinic/Center | 15630 Pinehurst Dr, Suite 5, Basehor, KS 66007-8233 | 2016-02-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821527243 | Catherine Eatherly | Case Manager/Care Coordinator | 1106 North 155th Street Ste B, Basehor, KS 66007 | 2017-06-08 |
| 1346651312 | Anndrina Pooja Mcgill | Case Manager/Care Coordinator | 1106 N. 155th Street, Suite B, Basehor, KS 66007 | 2014-05-13 |
| 1679911317 | Amanda Brown | Case Manager/Care Coordinator | 1006 North 155th Street, Basehor, KS 66007 | 2013-06-04 |
| 1821221151 | Ross Eugene Mccoy | Social Worker | 21825 155th Street, Basehor, KS 66007 | 2009-09-03 |
| 1992898308 | Deborah J Gammill | Family Medicine | 15604 Pinehurst Drive, Suite 2, Basehor, KS 66007 | 2006-09-30 |
| 1316453699 | Kori Staab | Behavior Technician | 1106 N 155th St, Basehor, KS 66007 | 2017-12-21 |
| 1740708312 | Erin Newkirk | Case Manager/Care Coordinator | 1106 North 155th Street Ste B, Basehor, KS 66007 | 2017-09-05 |
| 1801313994 | Ryan Emmitt | Case Manager/Care Coordinator | 1106 North 155th Street Ste B, Basehor, KS 66007 | 2017-08-29 |
| 1881117596 | Keeley Cowley | Case Manager/Care Coordinator | 1106 North 155th Street Ste B, Basehor, KS 66007 | 2017-07-25 |
| 1306375712 | Nicole Thompson | Case Manager/Care Coordinator | 1106 North 155th Street Ste B, Basehor, KS 66007 | 2017-06-08 |
| Find all providers in zip 66007 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457710790 | Jefferson County Memorial Hospital | Clinic/Center | 15630 Pinehurst Dr, Suite 5, Basehor, KS 66007-8233 | 2016-02-15 |
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| 1023627940 | Arena Health LLC | Clinic/Center | 8010 Stateline Road, Suite 100, Prairie Village, KS 66208 | 2020-07-27 |
| 1992326755 | M P Network LLC | Clinic/Center | 500 N Main St Ste 100, Newton, KS 67114-2200 | 2020-05-04 |
| 1386111649 | Kansas Diabetes and Endocrinology Center LLC | Clinic/Center | 3161 N Webb Rd, Suite 200, Wichita, KS 67226 | 2018-10-25 |
| 1457833378 | Chs Tennessee Medical P C | Clinic/Center | 2200 Nw Brickyard Rd, Topeka, KS 66618-2814 | 2018-09-06 |
| 1669905139 | Serc Rehabilitation Partners LLC | Clinic/Center | 2108 W 27th St, Ste K, Lawrence, KS 66047-3153 | 2017-04-11 |
| 1851775142 | Cardiac Cath Lab of Wichita Lp | Clinic/Center | 3555 North Webb Rd., Suite A, Wichita, KS 67226 | 2015-07-16 |
| 1447660360 | Jefferson County Memorial Hospital | Clinic/Center | 504 Plaza Dr, Suite 300, Perry, KS 66073-4136 | 2014-04-30 |
| 1861823403 | Serc Rehabilitation Partners LLC | Clinic/Center | 3627 Se 29th St, Ste 107, Topeka, KS 66605-2013 | 2013-12-09 |
| 1427312818 | Serc Rehabilitation Partners, LLC | Clinic/Center | 5799 Broadmoor St Ste 300, Mission, KS 66202-2421 | 2012-06-29 |
| 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.