MEDICARE: COMMONSPIRIT KANSAS, 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
1	207R00000X	Internal Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194438713
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMONSPIRIT KANSAS, INC.

Provider Business Mailing Address
First Line	:	PO BOX 803929
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64180-3929
Country	:	US
Telephone Number	:	888-347-3295
Fax Number	:	303-765-6670

Provider Business Practice Location Address
First Line	:	2300 N 14TH AVE STE 104
Second Line	:
City	:	DODGE CITY
State	:	KS
Zip	:	67801-2367
Country	:	US
Telephone Number	:	620-371-7010
Fax Number	:	620-371-7011

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. ANGELA JO SKINNER
Credential	:
Telephone Number	:	720-667-7283

Provider Enumeration Date	:	12/28/2022
Last Update Date	:	06/05/2025

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