| Fort Scott Family Medicine, P.a. | |
|
202 State St Suite A Fort Scott KS 66701-2031 | |
| (620) 223-3950 | |
| (620) 223-1302 |
| Full Name | Fort Scott Family Medicine, P.a. |
|---|---|
| Speciality | Family Medicine |
| Location | 202 State St, Fort Scott, Kansas |
| Authorized Official Name and Position | Ricky D Kellenberger (PRESIDENT) |
| Authorized Official Contact | 6202233950 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fort Scott Family Medicine, P.a. 202 State St Suite A Fort Scott KS 66701-2031 Ph: (620) 223-3950 | Fort Scott Family Medicine, P.a. 202 State St Suite A Fort Scott KS 66701-2031 Ph: (620) 223-3950 |
| NPI Number | 1467566802 |
|---|---|
| Provider Enumeration Date | 08/19/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 5991737512 |
|---|---|
| Medicare Enrollment ID | O20050905000016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467566802 | NPI | - | NPPES |
| 110645 | Other | KS | BLUE CROSS BLUE SHIELD |
| 2087370801 | Medicaid | KS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Ricky Don Kellenberger |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700864568 PECOS PAC ID: 1456340868 Enrollment ID: I20050415000650 |
| Provider Name | Randy V Kellenberger |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1932186681 PECOS PAC ID: 7012817927 Enrollment ID: I20120423000239 |
| Provider Name | Ryan Lewis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265839690 PECOS PAC ID: 9436317799 Enrollment ID: I20150121001734 |
| Provider Name | Heather D Burns |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093337701 PECOS PAC ID: 5092137216 Enrollment ID: I20200617000439 |
Community Health Center Of Southeast Kansas, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 401 Woodland Hills Blvd, Fort Scott, KS 66701 Phone: 620-223-8040 | |
Allen County Regional Surgical Associates Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 403 Woodland Hills Blvd, Fort Scott, KS 66701 Phone: 620-365-1234 | |
Girard Medical Center Of Fort Scott Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 109 S Main St, Fort Scott, KS 66701 Phone: 620-223-7008 | |
Mercy Clinic Fort Scott Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 403 Woodland Hills Blvd, Fort Scott, KS 66701 Phone: 620-223-8040 Fax: 620-223-8534 | |
Community Health Center Of Southeast Kansas, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2322 S Main St, Fort Scott, KS 66701 Phone: 620-231-9873 Fax: 620-231-5062 | |
Mercy Physician Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 403 Woodland Hills Blvd, Fort Scott, KS 66701 Phone: 620-223-8040 Fax: 620-223-8524 |