SUSAN B. ALLEN MEMORIAL HOSPITAL (NPI# 1922520832) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922520832 |
| Entity Type | Organization |
| Organization Name | SUSAN B. ALLEN MEMORIAL HOSPITAL |
| Other Organization Name | SBA MEDICAL GROUP - AUGUSTA |
| Practice Address |
401 W 7th Ave Augusta KS 67010-1309 |
| Mailing Address |
720 W Central Ave El Dorado KS 67042-2112 |
| Practice Telephone | 3165588668 |
| Enumeration Date | 2017-07-12 |
| Last Update Date | 2017-07-12 |
| Authorized Official Name | MR. MARK ROOKER (CIO/COO) |
| Authorized Official Telephone | 3163224544 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| SBA Medical Group - Augusta | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124594957 | Susan B. Allen Memorial Hospital | Emergency Medicine | 700 W Central Ave Ste 103, El Dorado, KS 67042-2187 | 2018-10-19 |
| 1588156574 | Susan B. Allen Memorial Hospital | Clinic/Center | 2710 W Central Ave, El Dorado, KS 67042-3285 | 2018-06-05 |
| 1003338914 | Susan B. Allen Memorial Hospital | Preventive Medicine | 720 W Central Ave Ste 111, El Dorado, KS 67042-2112 | 2017-07-12 |
| 1457766800 | Susan B. Allen Memorial Hospital | Family Medicine | 401 W 7th Ave, Augusta, KS 67010-1309 | 2014-06-24 |
| 1922431329 | Susan B. Allen Memorial Hospital | Orthopaedic Surgery | 700 W Central Ave Ste 108, El Dorado, KS 67042-2187 | 2013-08-21 |
| 1356783286 | Susan B. Allen Memorial Hospital | Otolaryngology | 700 W Central Ave Ste 202, El Dorado, KS 67042-2186 | 2013-07-19 |
| 1285870618 | Susan B. Allen Memorial Hospital | Family Medicine | 700 W Central Ave Ste 204, El Dorado, KS 67042-2186 | 2009-01-07 |
| 1700994977 | Susan B. Allen Memorial Hospital | Pharmacy | 720 W. Central Ave, El Dorado, KS 67042-2144 | 2006-08-28 |
| 1144724667 | Susan B. Allen Memorial Hospital | Audiologist | 700 W Central Ave Ste 202, El Dorado, KS 67042-2186 | 2018-03-20 |
| 1104349067 | Susan B. Allen Memorial Hospital | Hospitalist | 720 W Central Ave, El Dorado, KS 67042-2112 | 2017-07-24 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | SUSAN B. ALLEN MEMORIAL HOSPITAL, THE | 720 W Central Ave, El Dorado, KS 67042-2112 |
| Street Address |
401 W 7TH AVE |
| City | AUGUSTA |
| State | KS |
| Zip Code | 67010-1309 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457766800 | Susan B. Allen Memorial Hospital | Family Medicine | 401 W 7th Ave, Augusta, KS 67010-1309 | 2014-06-24 |
| 1891164695 | Lindsay Depperschmidt | Nurse Practitioner | 401 W 7th Ave, Augusta, KS 67010-1309 | 2015-09-22 |
| 1356350458 | Steve Bland | Physician Assistant | 401 W 7th Ave, Augusta, KS 67010-1309 | 2006-08-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407372444 | Kali Lauren Taylor | Pharmacist | 509 State Street, Augusta, KS 67010 | 2017-08-22 |
| 1952703068 | Connie Patten | Case Manager/Care Coordinator | 2821 Brookside Dr., Augusta, KS 67010 | 2014-09-19 |
| 1427461011 | Abby Bryan | Contractor | 6 Flanigan, Augusta, KS 67010 | 2014-06-11 |
| 1811252919 | Vicky T Kramer | Nurse Practitioner | 15707 Sw Us Hwy 77, Augusta, KS 67010 | 2012-07-05 |
| 1982816732 | Grene Vision Group LLC | Ophthalmology | 706 E Smiles, Augusta, KS 67010 | 2007-05-04 |
| 1205935384 | Patrick J Carman | Chiropractor | 517 State St, Augusta, KS 67010 | 2006-09-22 |
| 1114968047 | Dillon Companies LLC | Durable Medical Equipment & Medical Supplies | 1510 Ohio St, Augusta, KS 67010 | 2006-06-10 |
| 1154806552 | Hilary Alexandra Clark | Psychologist | 2821 Brookside Dr., Augusta, KS 67010 | 2018-10-01 |
| 1366845885 | Karly Klarisse Ross | Case Manager/Care Coordinator | 2821 Brookside Ct, Augusta, KS 67010 | 2014-09-29 |
| 1013319649 | Carla Morrow | Counselor | 2821 Brookside Ct, Augusta, KS 67010 | 2014-09-26 |
| Find all providers in zip 67010 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649889874 | Kateri Jeffery | Family Medicine | 12 Shuman Ave Ste 3, Augusta, ME 04330-6020 | 2020-07-23 |
| 1548885783 | Candace Clinton | Family Medicine | 1120 15th St # Hb4000, Augusta, GA 30912-0004 | 2020-06-13 |
| 1750906012 | Nand Vinod Patel | Family Medicine | 3039 Washington Rd, Augusta, GA 30907-3829 | 2020-06-12 |
| 1114542396 | Lauren C Robinson | Family Medicine | 1120 15th St # Hb3000e, Augusta, GA 30912-0004 | 2020-06-12 |
| 1831714211 | Soren Knudsen Estvold | Family Medicine | 1120 15th St # Hb-4000, Augusta, GA 30912-0004 | 2020-06-11 |
| 1548885940 | Hannah Gullickson Folsom | Family Medicine | 1459 Laney Walker Blvd Ae 3042, Augusta, GA 30912 | 2020-06-11 |
| 1942793005 | Rebecca Tate Jones | Family Medicine | 1120 15th St Augusta Ga 30912, Augusta, GA 30912-0001 | 2018-06-12 |
| 1811480411 | Sonya Janice Chelliah | Family Medicine | 1120 15th St # Hb3020, Augusta, GA 30912-0004 | 2018-06-08 |
| 1447741269 | Akua E Asiamah | Family Medicine | 1120 15th St Augusta University, Augusta, GA 30912-0001 | 2018-05-29 |
| 1457766800 | Susan B. Allen Memorial Hospital | Family Medicine | 401 W 7th Ave, Augusta, KS 67010-1309 | 2014-06-24 |
| Find all providers in AUGUSTA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.