| Pratt Family Practice Llc | |
|
203 Watson St Suite 200 Pratt KS 67124-3066 | |
| (620) 672-7422 | |
| (620) 508-6476 |
| Full Name | Pratt Family Practice Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 203 Watson St, Pratt, Kansas |
| Authorized Official Name and Position | Wakon Fowler (MEDICAL DIRECTOR) |
| Authorized Official Contact | 6206727422 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pratt Family Practice Llc 203 Watson St Suite 200 Pratt KS 67124-3066 Ph: (620) 672-7422 | Pratt Family Practice Llc 203 Watson St Suite 200 Pratt KS 67124-3066 Ph: (620) 672-7422 |
| NPI Number | 1740233204 |
|---|---|
| Provider Enumeration Date | 05/18/2006 |
| Last Update Date | 07/16/2015 |
| Medicare PECOS PAC ID | 6709824535 |
|---|---|
| Medicare Enrollment ID | O20050421000488 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740233204 | NPI | - | NPPES |
| 17-8987 | Other | KS | RHC PROVIDER # |
| 110446 | Other | KS | GROUP NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
| Provider Name | William Cannata |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457353732 PECOS PAC ID: 0143132027 Enrollment ID: I20050624000929 |
| Provider Name | John W Fowler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679577159 PECOS PAC ID: 6507802089 Enrollment ID: I20050706000883 |
| Provider Name | Lacie D Werkmeister |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952335689 PECOS PAC ID: 2769486539 Enrollment ID: I20060909000017 |
| Provider Name | Steven R Donnenwerth |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659361632 PECOS PAC ID: 2163313719 Enrollment ID: I20070220000417 |
| Provider Name | Eric R Clarkson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982802807 PECOS PAC ID: 4587798418 Enrollment ID: I20100814000015 |
| Provider Name | Micha Shea Kessler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629331962 PECOS PAC ID: 8325363351 Enrollment ID: I20150213000576 |
| Provider Name | Sarah Ann Eubank |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548509359 PECOS PAC ID: 9234377425 Enrollment ID: I20150227000538 |
| Provider Name | Hannah K Vogt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942793385 PECOS PAC ID: 4880943315 Enrollment ID: I20210721002896 |
| Provider Name | Christa Janelle Titus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861204554 PECOS PAC ID: 0749710689 Enrollment ID: I20250207001584 |
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