PRAIRIE BAND POTAWATOMI HEALTH CENTER – NPI #1245266410
Clinic/Center

PRAIRIE BAND POTAWATOMI HEALTH CENTER is an AHC clinic located in MAYETTA, KS. NPPES has assigned the NPI number 1245266410 to PRAIRIE BAND POTAWATOMI HEALTH CENTER on June 22, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “PRAIRIE BAND POTAWATOMI HEALTH CENTER” is a dba name, the actual legal business name for this organization is PRAIRIE BAND POTAWATOMI NATION. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 261QF0400X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Federally Qualified Health Center (FQHC)

The NPI profile was previously updated about 4 years ago on Jul 21, 2022. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for PRAIRIE BAND POTAWATOMI HEALTH CENTER below.

NPI Profile for
PRAIRIE BAND POTAWATOMI NATION

NPI Number
1245266410
Enumeration Date

(about 20 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
PRAIRIE BAND POTAWATOMI NATION
Doing Business As (dba): PRAIRIE BAND POTAWATOMI HEALTH CENTER
Primary location
11400 158TH RD
MAYETTA, KS 66509-0249
Phone: (785) 966-8200 Fax: (785) 966-8393
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
TIFFANY LEWIS
BUSINESS OFFICE MANAGER
Phone: (785) 966-8282
Updated
Certification Date
Jun 01, 2022

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for PRAIRIE BAND POTAWATOMI HEALTH CENTER

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDKS200259300A
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QF0400X
- Clinic/Center / Federally Qualified Health Center (FQHC) (Primary)
261QH0100X
- Clinic/Center / Health Service		 KS

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.