| Greensburg Family Practice | |
|
721 W Kansas Ave Greensburg KS 67054-1633 | |
| (620) 723-3341 | |
| (620) 508-2067 |
| Full Name | Greensburg Family Practice |
|---|---|
| Speciality | Clinic/Center |
| Location | 721 W Kansas Ave, Greensburg, Kansas |
| Authorized Official Name and Position | Morgan Renee Allison (CEO) |
| Authorized Official Contact | 6207234203 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Greensburg Family Practice 721 W Kansas Ave Greensburg KS 67054-1633 Ph: (620) 723-3341 | Greensburg Family Practice 721 W Kansas Ave Greensburg KS 67054-1633 Ph: (620) 723-3341 |
| NPI Number | 1063009819 |
|---|---|
| Provider Enumeration Date | 12/28/2020 |
| Last Update Date | 01/19/2024 |
| Medicare PECOS PAC ID | 9638589369 |
|---|---|
| Medicare Enrollment ID | O20210223001457 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063009819 | NPI | - | NPPES |
| 100303090C | Medicaid | KS | |
| 30003956420007 | Medicaid | KS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
| Provider Name | Fredrick J Farmer |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1174612105 PECOS PAC ID: 0244206688 Enrollment ID: I20040907001024 |
| 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 | Clint M Colberg |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558337287 PECOS PAC ID: 9133156581 Enrollment ID: I20050718000907 |
| Provider Name | John Bukaty |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588634224 PECOS PAC ID: 2668407602 Enrollment ID: I20050930000592 |
| Provider Name | Vincent O Mogoi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386181832 PECOS PAC ID: 5294010070 Enrollment ID: I20170317000112 |
| Provider Name | Naveen Penmasta |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447697750 PECOS PAC ID: 7810294337 Enrollment ID: I20200131000696 |
| Provider Name | Raafia Memon |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1144646738 PECOS PAC ID: 2961703657 Enrollment ID: I20231004003340 |
| Provider Name | Sujata Sarkar |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1194800607 PECOS PAC ID: 0547223786 Enrollment ID: I20231016000446 |
| Provider Name | Christopher Liedke |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1982022943 PECOS PAC ID: 1658612726 Enrollment ID: I20231020002347 |
| Provider Name | Emily Gilbert |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1649627928 PECOS PAC ID: 2062782345 Enrollment ID: I20231025003349 |
| Provider Name | Sheba Syeda Asghar |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1780865758 PECOS PAC ID: 2567543150 Enrollment ID: I20231031002238 |
| Provider Name | Joshua M White |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1083729933 PECOS PAC ID: 1557368222 Enrollment ID: I20231130000873 |
| Provider Name | Priyanka Agarwal |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1326466145 PECOS PAC ID: 9133436512 Enrollment ID: I20240202000608 |
| Provider Name | Cory Lynn Straub |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1154634996 PECOS PAC ID: 8628399045 Enrollment ID: I20240229002826 |
County Of Kiowa. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 211 E Florida Ave, Greensburg, KS 67054 Phone: 620-723-2136 Fax: 620-723-2943 | |
Greensburg Family Practice (non Rhc) Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 721 W Kansas Ave, Greensburg, KS 67054 Phone: 620-723-2127 |