Integris Caldwell Family Clinic | |
415 S Osage St Caldwell KS 67022-1650 | |
(620) 845-2516 | |
Not Available |
Full Name | Integris Caldwell Family Clinic |
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Speciality | Family Medicine |
Location | 415 S Osage St, Caldwell, Kansas |
Authorized Official Name and Position | Chris Hammes (SENIOR VICE PRESIDENT & COO) |
Authorized Official Contact | 4059493402 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Integris Caldwell Family Clinic 5400 N Independence Ave Ste 200 Oklahoma City OK 73112-5300 Ph: (405) 713-5515 | Integris Caldwell Family Clinic 415 S Osage St Caldwell KS 67022-1650 Ph: (620) 845-2516 |
NPI Number | 1942201397 |
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Provider Enumeration Date | 08/09/2005 |
Last Update Date | 03/29/2022 |
Medicare PECOS PAC ID | 0345151981 |
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Medicare Enrollment ID | O20050419000843 |
Identifier | Type | State | Issuer |
---|---|---|---|
1942201397 | NPI | - | NPPES |
100755850B | Other | OK | OK MEDICAID FFS |
100100440 C | Other | KS | KS MEDICAID RHC |
100193490E | Other | OK | OK MEDICAID SC |
100699500P | Other | OK | OK MEDICAID RHC |
100699500P | Medicaid | OK | |
100100440 D | Other | KS | KS MEDICAID FFS |
460169 | Other | KS | KS RHC CHILD MERCY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Jim D Blunk |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1962402537 PECOS PAC ID: 1153387220 Enrollment ID: I20050506000441 |
Provider Name | Molly Kay Partee |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1376063321 PECOS PAC ID: 6800166919 Enrollment ID: I20170724000825 |
Provider Name | Amanda Rigney |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1316578842 PECOS PAC ID: 8921401522 Enrollment ID: I20210720002237 |
Caldwell Family Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 761 W 175th St S, Caldwell, KS 67022 Phone: 620-845-6492 Fax: 620-845-2518 |