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	251G00000X	Community Based Hospice Care Agency

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	:	1306826144
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMONSPIRIT KANSAS, INC.

Provider Business Mailing Address
First Line	:	401 E SPRUCE ST
Second Line	:
City	:	GARDEN CITY
State	:	KS
Zip	:	67846-5679
Country	:	US
Telephone Number	:	620-272-2519
Fax Number	:	620-272-2664

Provider Business Practice Location Address
First Line	:	602 N 6TH ST
Second Line	:
City	:	GARDEN CITY
State	:	KS
Zip	:	67846-5509
Country	:	US
Telephone Number	:	620-272-2519
Fax Number	:	620-272-2664

Authorized Official
Title or Position	:	VP FINANCE & CFO
Name	:	MRS. SHAWNA R ROARK
Credential	:
Telephone Number	:	620-272-2222

Provider Enumeration Date	:	01/18/2006
Last Update Date	:	06/03/2025

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