| Satanta District Hospital Clinic - Non Rural Health | |
|
410 Cheyenne Street Satanta KS 67870-0009 | |
| (620) 649-2771 | |
| (620) 649-2538 |
| Full Name | Satanta District Hospital Clinic - Non Rural Health |
|---|---|
| Speciality | Family Medicine |
| Location | 410 Cheyenne Street, Satanta, Kansas |
| Authorized Official Name and Position | Tina Pendergraft (ADMINISTRATOR) |
| Authorized Official Contact | 6206492761 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Satanta District Hospital Clinic - Non Rural Health Po Box 9 Satanta KS 67870-0009 Ph: (620) 649-2771 | Satanta District Hospital Clinic - Non Rural Health 410 Cheyenne Street Satanta KS 67870-0009 Ph: (620) 649-2771 |
| NPI Number | 1144312844 |
|---|---|
| Provider Enumeration Date | 09/29/2006 |
| Last Update Date | 01/27/2021 |
| Medicare PECOS PAC ID | 5991616054 |
|---|---|
| Medicare Enrollment ID | O20040311001369 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144312844 | NPI | - | NPPES |
| 110220 | Other | KS | NON RURAL HEALTH NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | H041001 (Kansas) | Primary |
| 208VP0014X | Pain Medicine - Interventional Pain Medicine | (* (Not Available)) | Secondary |
| Provider Name | Amy R Nightengale |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306876933 PECOS PAC ID: 8325072663 Enrollment ID: I20050926000506 |
| Provider Name | Peggy A Parker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497192439 PECOS PAC ID: 1850535329 Enrollment ID: I20130924000116 |
| Provider Name | Christine C Tardif |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437133428 PECOS PAC ID: 2466581400 Enrollment ID: I20181227000869 |
| Provider Name | Brian Jennings |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386024800 PECOS PAC ID: 8921316456 Enrollment ID: I20190225000966 |
| Provider Name | Jason L Hoke |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992969661 PECOS PAC ID: 6507196300 Enrollment ID: I20190920001972 |
| Provider Name | Philip Caravella |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336252931 PECOS PAC ID: 1759386279 Enrollment ID: I20240430002088 |
| Provider Name | Henry Derbes |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1912434978 PECOS PAC ID: 7911389622 Enrollment ID: I20240610001907 |
Satanta District Hospital Clinic-satanta Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 410 Cheyenne, Satanta, KS 67870 Phone: 620-649-2771 Fax: 620-649-2538 |