| Kickapoo Nation Health Center | |
|
1117 Goldfinch Rd Horton KS 66439-9537 | |
| (785) 915-9751 | |
| (785) 329-4798 |
| Full Name | Kickapoo Nation Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 1117 Goldfinch Rd, Horton, Kansas |
| Authorized Official Name and Position | Jonnah D Mckinney (ADMINISTRATOR) |
| Authorized Official Contact | 7859159751 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kickapoo Nation Health Center 1117 Goldfinch Rd Horton KS 66439-9537 Ph: (785) 915-9751 | Kickapoo Nation Health Center 1117 Goldfinch Rd Horton KS 66439-9537 Ph: (785) 915-9751 |
| NPI Number | 1992806012 |
|---|---|
| Provider Enumeration Date | 09/25/2006 |
| Last Update Date | 07/21/2026 |
| Certification Date | 07/21/2026 |
| Medicare PECOS PAC ID | 0749228930 |
|---|---|
| Medicare Enrollment ID | O20151125000247 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992806012 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP0904X | Clinic/center - Public Health, Federal | () | Primary |
| Provider Name | Michelle L Koch-shamburg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386740892 PECOS PAC ID: 6103857032 Enrollment ID: I20190722003401 |
| Provider Name | Richard L Brown |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114029428 PECOS PAC ID: 7911938733 Enrollment ID: I20190910000241 |
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