{
"Npi": {
"NPI": "1013849322",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "COMMUNITY HEALTH CENTER OF SOUTHEAST KANSAS, INC.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 1832",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PITTSBURG",
"MailingAddressStateName": "KS",
"MailingAddressPostalCode": "66762-1832",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "620-240-5668",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "800 W LAUREL ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "INDEPENDENCE",
"PracticeLocationAddressStateName": "KS",
"PracticeLocationAddressPostalCode": "67301-3211",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "620-577-2131",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "06/01/2026",
"LastUpdateDate": "06/04/2026",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MONTOJO",
"AuthorizedOfficialFirstName": "JIAWEI",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "CREDENTIALING MANAGER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "620-240-5668",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "261QM1300X",
"TaxonomyName": "Multi-Specialty Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "261QF0400X",
"TaxonomyName": "Federally Qualified Health Center (FQHC)",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}