| Kevin Hamm, DO,PA | |
|
629 S Plummer Ave, Chanute, KS 66720-1928 | |
| (316) 755-0482 | |
| (316) 755-0458 |
| Full Name | Kevin Hamm |
|---|---|
| Gender | Male |
| Speciality | Diagnostic Radiology |
| Experience | 34 Years |
| Location | 629 S Plummer Ave, Chanute, Kansas |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578657623 | NPI | - | NPPES |
| 48-1235274 | Other | KS | TAX ID # |
| 05-26968 | Other | KS | LISCENSE |
| 100297360C | Medicaid | KS | |
| 058849 | Other | KS | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | 05-26968 (Kansas) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Neosho Memorial Regional Medical Center | Chanute, KS | Hospital |
| Kiowa District Hospital | Kiowa, KS | Hospital |
| Medicine Lodge Memorial Hospital | Medicine lodge, KS | Hospital |
| Saint Francis Hospital Muskogee | Muskogee, OK | Hospital |
| Alliancehealth Midwest | Midwest city, OK | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Choctaw Nation Of Oklahoma | 1759294838 | 274 |
| Cherokee Nation | 5799698742 | 438 |
| Creek Nation Hospital And Clinics | 5698786226 | 383 |
| Creek Nation Hospital And Clinics | 5698786226 | 383 |
| Clinton Indian Health Center | 2163324237 | 71 |
| Pawnee Indian Health Center | 2769470160 | 95 |
| Lawton Indian Hospital | 6406800234 | 125 |
| El Reno Indian Health Center | 5193627263 | 48 |
| Diagnostic Imaging Associates Inc | 8820083645 | 84 |
| Sumner County Hospital District No 1 | 6103925268 | 19 |
| Albuquerque Indian Health Center | 7719883164 | 53 |
| Pine Ridge Indian Health Service Hospital | 4688571326 | 105 |
| Zuni Indian Hospital | 5698689644 | 48 |
| Entity Name | Taos Picuris Health Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1548372071 PECOS PAC ID: 5193638245 Enrollment ID: O20031106000188 |
| Entity Name | Choctaw Nation Of Oklahoma |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1659347623 PECOS PAC ID: 1759294838 Enrollment ID: O20031106000326 |
| Entity Name | Cherokee Nation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1780692723 PECOS PAC ID: 5799698742 Enrollment ID: O20031106000628 |
| Entity Name | Zuni Indian Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1497843734 PECOS PAC ID: 5698689644 Enrollment ID: O20031114000284 |
| Entity Name | Albuquerque Indian Health Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1659458917 PECOS PAC ID: 7719883164 Enrollment ID: O20031208001026 |
| Entity Name | Claremore Indian Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1073527842 PECOS PAC ID: 9436069911 Enrollment ID: O20031210001104 |
| Entity Name | Pine Ridge Indian Health Service Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1497786412 PECOS PAC ID: 4688571326 Enrollment ID: O20031218000966 |
| Entity Name | El Reno Indian Health Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1386725604 PECOS PAC ID: 5193627263 Enrollment ID: O20040121000487 |
| Entity Name | Clinton Indian Health Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1205923448 PECOS PAC ID: 2163324237 Enrollment ID: O20040121000506 |
| Entity Name | Eagle Butte Indian Health Service Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1558395848 PECOS PAC ID: 7517852759 Enrollment ID: O20040217001024 |
| Entity Name | Pawnee Indian Health Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1629174081 PECOS PAC ID: 2769470160 Enrollment ID: O20040504001225 |
| Entity Name | Wewoka Indian Health |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1689664195 PECOS PAC ID: 7517911415 Enrollment ID: O20050303000367 |
| Entity Name | Lawton Indian Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1760489223 PECOS PAC ID: 6406800234 Enrollment ID: O20050304000301 |
| Entity Name | Anadarko Indian Health Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1881637403 PECOS PAC ID: 7719931559 Enrollment ID: O20050304000365 |
| Entity Name | Laguna Healthcare Corporation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1962001024 PECOS PAC ID: 2365855079 Enrollment ID: O20210119000388 |
| Entity Name | Creek Nation Hospital & Clinics |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1467053173 PECOS PAC ID: 5698786226 Enrollment ID: O20210226001928 |
| Mailing Address | Practice Location Address |
|---|---|
| Kevin Hamm, DO,PA Po Box 397, Valley Center, KS 67147-0397 Ph: (316) 755-0482 | Kevin Hamm, DO,PA 629 S Plummer Ave, Chanute, KS 66720-1928 Ph: (316) 755-0482 |
Mark Witaczack, DO Radiology Medicare: Not Enrolled in Medicare Practice Location: 629 S Plummer, Chanute, KS 66720 Phone: 316-321-5900 Fax: 316-321-4763 |