Provider Demographics
NPI: | 1871588533 |
---|---|
Name: | NEWTON HEALTHCARE CORPORATION |
Entity type: | Organization |
Organization Name: | NEWTON HEALTHCARE CORPORATION |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | PRESIDENT & CHIEF EXECUTIVE OFFICER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | VALLERIE |
Authorized Official - Middle Name: | L |
Authorized Official - Last Name: | GLEASON |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 316-283-2700 |
Mailing Address - Street 1: | 600 MEDICAL CENTER DR |
Mailing Address - Street 2: | |
Mailing Address - City: | NEWTON |
Mailing Address - State: | KS |
Mailing Address - Zip Code: | 67114-8780 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 316-283-2700 |
Mailing Address - Fax: | 316-804-6045 |
Practice Address - Street 1: | 600 MEDICAL CENTER DR |
Practice Address - Street 2: | |
Practice Address - City: | NEWTON |
Practice Address - State: | KS |
Practice Address - Zip Code: | 67114-8780 |
Practice Address - Country: | US |
Practice Address - Phone: | 316-283-2700 |
Practice Address - Fax: | 316-804-6045 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2005-09-19 |
Last Update Date: | 2020-07-20 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | Group - Multi-Specialty | |
No | 133V00000X | Dietary & Nutritional Service Providers | Dietitian, Registered | Group - Multi-Specialty | |
No | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty | |
No | 207X00000X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Group - Multi-Specialty | |
No | 208100000X | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | Group - Multi-Specialty | |
No | 208600000X | Allopathic & Osteopathic Physicians | Surgery | Group - Multi-Specialty | |
No | 208M00000X | Allopathic & Osteopathic Physicians | Hospitalist | Group - Multi-Specialty | |
No | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Group - Multi-Specialty | |
No | 225X00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Group - Multi-Specialty | |
No | 235Z00000X | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | Group - Multi-Specialty | |
No | 363A00000X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Group - Multi-Specialty | |
No | 363L00000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Group - Multi-Specialty |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
KS | 111178 | Other | BLUE SHIELD COMMON PAY # |
KS | 111178 | Medicare ID - Type Unspecified | MEDICARE GROUP PROVIDER |