Healthcare Provider Details

I. General information

NPI: 1932031341
Provider Name (Legal Business Name): ACORNS TO OAKS PEDIATRIC PSYCHIATRY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 E MAPLE ST
COLUMBUS KS
66725-1802
US

IV. Provider business mailing address

1113 W PINE ST
COLUMBUS KS
66725-1557
US

V. Phone/Fax

Practice location:
  • Phone: 620-429-5314
  • Fax:
Mailing address:
  • Phone: 913-850-0375
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MADISON R RAY
Title or Position: CEO
Credential: MBA, CTRS
Phone: 913-850-0375