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NPI Code Detail

MEDICARE: HEART OF KANSAS FAMILY HEALTH CARE, INC.

MEDICARE: HEART OF KANSAS FAMILY HEALTH CARE, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician
2261QF0400XFederally Qualified Health Center (FQHC)

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
4DC6555OTHERKSRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2461035OTHERKSCHILDRENS MERCY
3160510OTHERKSBLUE SHIELD

General Provider Information

NPI Number : 1184739443
Entity Type Code : Organization
Provider Name (Legal Business Name) : HEART OF KANSAS FAMILY HEALTH CARE, INC.
Provider Business Mailing Address
First Line : 1905 19TH ST
Second Line :
City : GREAT BEND
State : KS
Zip : 67530-2502
Country : US
Telephone Number : 620-792-5700
Fax Number : 855-463-0851
Provider Business Practice Location Address
First Line : 1905 19TH ST
Second Line :
City : GREAT BEND
State : KS
Zip : 67530-2502
Country : US
Telephone Number : 620-792-5700
Fax Number : 855-463-0851
Authorized Official
Title or Position : CFO
Name : MR. FREDDY GUNN
Credential :
Telephone Number : 620-792-5700
Provider Enumeration Date : 08/20/2006
Last Update Date : 05/08/2026

Similar Medicare Providers

1700853926 — DR. OZOEMENAM IMMANUEL UKETUI MD
Practice Location Address:
1905 19TH ST
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67530-2502
Practice Phone: 620-792-5700
Practice Fax: 620-792-5742
1912957580 — JEAN PRINGLE M.D.
Practice Location Address:
1905 19TH ST
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1376593947 — JEANNE L HABASH PA-C
Practice Location Address:
1905 19TH ST
GREAT BEND, KS
67530-2502
Practice Phone: 620-792-5700
Practice Fax: 855-463-0851
1629196605 — MRS. CARIE ELIZABETH BROWN MSW LSCSW
Practice Location Address:
1905 19TH ST
GREAT BEND, KS
67530-2502
Practice Phone: 620-792-2544
Practice Fax: 620-792-7052
1588994800 — JANNIFER L BOUCHER LPC
Practice Location Address:
1905 19TH ST
GREAT BEND, KS
67530-2502
Practice Phone: 620-792-5700
Practice Fax: 620-792-5742
1538462239 — MRS. RITA ANN O'GWIN LSCSW
Practice Location Address:
1905 19TH ST
GREAT BEND, KS
67530-2502
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Practice Fax:

Directions to “HEART OF KANSAS FAMILY HEALTH CARE, INC. ” Practice Location

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