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625 Kentucky St Ashland KS 67831-3199 | |
| (620) 635-2241 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 625 Kentucky St, Ashland, Kansas |
| Authorized Official Name and Position | Sandrea Wright (ADMINISTRATIVE) |
| Authorized Official Contact | 6206352241 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 188 Ashland KS 67831-0188 Ph: (620) 635-2241 | 625 Kentucky St Ashland KS 67831-3199 Ph: (620) 635-2241 |
| NPI Number | 1073686002 |
|---|---|
| Provider Enumeration Date | 11/16/2006 |
| Last Update Date | 03/31/2022 |
| Medicare PECOS PAC ID | 6800849324 |
|---|---|
| Medicare Enrollment ID | O20050228000908 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073686002 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 013001 (Kansas) | Primary |
| Provider Name | Scott L Stringfield |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093710063 PECOS PAC ID: 8123064581 Enrollment ID: I20050707000379 |
| Provider Name | Tamara L Shaw |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740397173 PECOS PAC ID: 2668401126 Enrollment ID: I20050805000249 |
| Provider Name | James W Moffitt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346205929 PECOS PAC ID: 0840109765 Enrollment ID: I20080131000630 |
| Provider Name | Casandra L Butler |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023270014 PECOS PAC ID: 0244389427 Enrollment ID: I20090518000496 |
| Provider Name | Lisa M Gilbert |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396973848 PECOS PAC ID: 1254523970 Enrollment ID: I20101012001362 |
| Provider Name | Daniel Keith Shuman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376513978 PECOS PAC ID: 0547234742 Enrollment ID: I20110818000851 |
| Provider Name | Jose L Renteria |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053704361 PECOS PAC ID: 1951629963 Enrollment ID: I20150422001832 |
| Provider Name | Mohammad M Hassan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326049420 PECOS PAC ID: 9739121781 Enrollment ID: I20160907002401 |
| Provider Name | Brianne Clark |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497980254 PECOS PAC ID: 4688821085 Enrollment ID: I20171020001587 |
| Provider Name | Macy Rupprecht |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558719856 PECOS PAC ID: 4880988518 Enrollment ID: I20171110001575 |
| Provider Name | Stephanie J Salisbury |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740588953 PECOS PAC ID: 7315295508 Enrollment ID: I20180803001930 |
| Provider Name | Sean M Davies |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083964274 PECOS PAC ID: 5890931208 Enrollment ID: I20181213000773 |
| Provider Name | Jason L Hoke |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992969661 PECOS PAC ID: 6507196300 Enrollment ID: I20190920001972 |
| Provider Name | Dedra R Rathgeber |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902488505 PECOS PAC ID: 4385045194 Enrollment ID: I20210630004157 |
| Provider Name | Julien H Atis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952962938 PECOS PAC ID: 8729314471 Enrollment ID: I20220829000430 |
| Provider Name | Taylor A Russell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770140121 PECOS PAC ID: 0143556894 Enrollment ID: I20220831000352 |
| Provider Name | John Herbert Borkert |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699033951 PECOS PAC ID: 1951526151 Enrollment ID: I20230825001302 |
| Provider Name | Timothy Aaron Hanson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1801852173 PECOS PAC ID: 0648379305 Enrollment ID: I20230927002996 |
| Provider Name | Matthew Brettmann |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518540434 PECOS PAC ID: 1355724022 Enrollment ID: I20240831000383 |