GEARY COUNTY HOSPITAL (GCH RURAL HEALTH CLINIC) - NPI NUMBER 1447467162

Summary

Provider Name: GEARY COUNTY HOSPITAL (GCH RURAL HEALTH CLINIC)

NPI Number: 1447467162

Clasification: Internal Medicine (207RG0300X)

Specialization: Geriatric Medicine

Address:
1106 SAINT MARYS RD
SUITE 307
JUNCTION CITY, KS
ZIP 66441

Phone Number: (785) 762-4255



Detailed Information

GEARY COUNTY HOSPITAL is a geriatric medicine internist in Junction City, KS. The provider is an internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital. The assigned NPI number for this provider is 1447467162 and is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Gch Rural Health Clinic.

The provider's business address is:

1106 SAINT MARYS RD
SUITE 307
JUNCTION CITY, KS
ZIP 66441-158
Phone: (785) 762-4255
Fax: (785) 762-2859

The provider's authorized official is David K Bradley .
The authorized official title is Ceo and has the following contact phone number (785) 238-4131.

The enumeration date for this NPI number is 5/16/2007 and was last updated on 6/14/2012.

Map - Location of Practice

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Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 207RG0300X Internal Medicine Geriatric Medicine 04-19045 KS No
2 261QR1300X Clinic/Center Rural Health Yes

Other (Legacy) Identifiers

The following legacy identifiers are available for this provider:

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1 B68651 MEDICARE UPIN KS
2 10193980A MEDICAID KS
3 002009 MEDICARE ID-TYPE UNSPECIFIED KS

NPI Record

No. Field Name Field Value Field Definition 1
1 NPI 1447467162 The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
2 Entity Type Code 2 Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
3 Employer Identification Number EIN The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
4 Provider Organization Name Legal Business Name GEARY COUNTY HOSPITAL The name of the organization provider. If the provider is an organization, this is the legal business name.
5 Provider Other Organization Name GCH RURAL HEALTH CLINIC Other name by which the organization provider is or has been known.
6 Provider Other Organization Name Type Code 3 Code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/ a) name; 4 = former legal business name; 5 = other.
7 Provider First Line Business Practice Location Address 1106 SAINT MARYS RD The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
8 Provider Second Line Business Practice Location Address SUITE 307 The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
9 Provider Business Practice Location Address City Name JUNCTION CITY The city name in the location address of the provider being identified.
10 Provider Business Practice Location Address State Name KS The State code in the location of the provider being identified.
11 Provider Business Practice Location Address Postal Code 664414158 The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
12 Provider Business Practice Location Address Country Code If outside U S US The country code in the location address of the provider being identified.
13 Provider Business Practice Location Address Telephone Number 7857624255 The telephone number associated with the location address of the provider being identified.
14 Provider Business Practice Location Address Fax Number 7857622859 The fax number associated with the location address of the provider being identified.
15 Provider Enumeration Date 5/16/2007 The date the provider was assigned a unique identifier (assigned an NPI).
16 Last Update Date 6/14/2012 The date that a record was last updated or changed.
17 Authorized Official Last Name BRADLEY The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
18 Authorized Official First Name DAVID The first name of the authorized official.
19 Authorized Official Middle Name K The middle name of the authorized official.
20 Authorized Official Title or Position CEO The title or position of the authorized official.
21 Authorized Official Telephone Number 7852384131 The 10-position telephone number of the authorized official.
22 Healthcare Provider Taxonomy Code 1 207RG0300X Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
23 Provider License Number 1 04-19045 The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
24 Provider License Number State Code 1 KS The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
25 Healthcare Provider Primary Taxonomy Switch 1 N
26 Healthcare Provider Taxonomy Code 2 261QR1300X
27 Healthcare Provider Primary Taxonomy Switch 2 Y
28 Other Provider Identifier 1 B68651 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
29 Other Provider Identifier Type Code 1 02 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
30 Other Provider Identifier State 1 KS
31 Other Provider Identifier 2 10193980A Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
32 Other Provider Identifier Type Code 2 05 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
33 Other Provider Identifier State 2 KS
34 Other Provider Identifier 3 002009 Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
35 Other Provider Identifier Type Code 3 04
36 Other Provider Identifier State 3 KS Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
37 Is Organization Subpart Y Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
38 Parent Organization LBN GEARY COUNTY HOSPITAL
39 Parent Organization TIN
40 Healthcare Provider Taxonomy Group 1 193200000X MULTI-SPECIALTY GROUP

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This page was last updated on: 3/10/2015

(1) Field Definition Source-. Federal Register / Vol. 69, No. 15 / Friday, January 23, 2004 / Rules and Regulations - Part II Department of Health and Human Services Office of the Secretary 45 CFR Part 162 HIPAA Administrative Simplification: Standard Unique Health Identifier for Health Care Providers; Final Rule

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