Healthcare Provider Details

I. General information

NPI: 1205549821
Provider Name (Legal Business Name): COMMONSPIRIT KANSAS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/28/2022
Last Update Date: 06/05/2025
Certification Date: 06/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 W ROSS BLVD STE 1B
DODGE CITY KS
67801-7217
US

IV. Provider business mailing address

PO BOX 803929
KANSAS CITY MO
64180-3929
US

V. Phone/Fax

Practice location:
  • Phone: 620-371-5576
  • Fax: 620-371-5006
Mailing address:
  • Phone: 888-347-3295
  • Fax: 303-765-6670

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ANGELA JO SKINNER
Title or Position: ADMINISTRATOR
Credential:
Phone: 720-667-7283