| Great Plains Of Ellinwood Inc. | |
|
300 N Park Ave Ellinwood KS 67526-1452 | |
| (620) 564-2548 | |
| (620) 564-2491 |
| Full Name | Great Plains Of Ellinwood Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 300 N Park Ave, Ellinwood, Kansas |
| Authorized Official Name and Position | Kile Magner (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 6205642548 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Great Plains Of Ellinwood Inc. 300 N Park Ave Ellinwood KS 67526-1452 Ph: (620) 564-2548 | Great Plains Of Ellinwood Inc. 300 N Park Ave Ellinwood KS 67526-1452 Ph: (620) 564-2548 |
| NPI Number | 1225040256 |
|---|---|
| Provider Enumeration Date | 08/11/2006 |
| Last Update Date | 07/17/2024 |
| Medicare PECOS PAC ID | 5092627539 |
|---|---|
| Medicare Enrollment ID | O20031103000510 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225040256 | NPI | - | NPPES |
| 1000410070B | Medicaid | KS | |
| 000964 | Other | KS | BCBS 2NDRY FOR RHC |
| 110746 | Other | KS | BLUE CROSS |
| 110746 | Other | KS | MEDICARE PTAN |
| 173402 | Other | KS | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (Kansas) | Primary |
| Provider Name | David W Sanger |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306896972 PECOS PAC ID: 8224920467 Enrollment ID: I20040325000215 |
| Provider Name | Charlie G Joslin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831172733 PECOS PAC ID: 2365437035 Enrollment ID: I20040420001063 |
| Provider Name | Christopher M Brown |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659379113 PECOS PAC ID: 4688652092 Enrollment ID: I20040712001185 |
| Provider Name | Gary B Morsch |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851367809 PECOS PAC ID: 4981595931 Enrollment ID: I20040910001119 |
| Provider Name | Jenifer P Cook |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104809987 PECOS PAC ID: 9931165008 Enrollment ID: I20041209000804 |
| Provider Name | Timothy Lawton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780686063 PECOS PAC ID: 5193765451 Enrollment ID: I20050506000139 |
| Provider Name | Bryce J Loder |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134152762 PECOS PAC ID: 1951342617 Enrollment ID: I20050512000903 |
| Provider Name | Jeffery W Mckinley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417953365 PECOS PAC ID: 1951345743 Enrollment ID: I20050613001044 |
| Provider Name | Kathy L Wyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639161052 PECOS PAC ID: 3375578883 Enrollment ID: I20051004000567 |
| Provider Name | Diane E Haines |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598936981 PECOS PAC ID: 8224104005 Enrollment ID: I20080902000123 |
| Provider Name | Jose L Renteria |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053704361 PECOS PAC ID: 1951629963 Enrollment ID: I20150422001832 |
| Provider Name | Jacob L Cloward |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962931873 PECOS PAC ID: 2466723788 Enrollment ID: I20190715001817 |
| Provider Name | Shelbi T Frees |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952175309 PECOS PAC ID: 5698124220 Enrollment ID: I20231208000191 |
Innovative Visions Consulting Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1450 Se 50 Rd, Ellinwood, KS 67526 Phone: 620-450-6275 | |
Advanced Practice Specialties, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 505 N Main St, Ellinwood, KS 67526 Phone: 620-639-0238 |