Healthcare Provider Details

I. General information

NPI: 1447968128
Provider Name (Legal Business Name): STORMONT VAIL HEALTH FLINT HILLS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/10/2022
Last Update Date: 12/19/2023
Certification Date: 12/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1102 SAINT MARYS RD
JUNCTION CITY KS
66441-4139
US

IV. Provider business mailing address

1102 SAINT MARYS RD
JUNCTION CITY KS
66441-4139
US

V. Phone/Fax

Practice location:
  • Phone: 785-210-3303
  • Fax:
Mailing address:
  • Phone: 785-210-3303
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State

VIII. Authorized Official

Name: PEGGY J BURNETTE
Title or Position: SVP/CFO
Credential:
Phone: 785-354-6148