Provider Demographics
NPI: | 1760408975 |
---|---|
Name: | ASCENSION VIA CHRISTI HOSPITAL PITTSBURG, INC. |
Entity Type: | Organization |
Organization Name: | ASCENSION VIA CHRISTI HOSPITAL PITTSBURG, INC. |
Other - Org Name: | PROFESSIONAL SERVICES |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | DIRECTOR |
Authorized Official - Prefix: | |
Authorized Official - First Name: | CHARLOTTE |
Authorized Official - Middle Name: | ANNE |
Authorized Official - Last Name: | RUSSELL |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 620-235-7926 |
Mailing Address - Street 1: | 1 MT. CARMEL WAY |
Mailing Address - Street 2: | |
Mailing Address - City: | PITTSBURG |
Mailing Address - State: | KS |
Mailing Address - Zip Code: | 66762-6643 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 620-235-7995 |
Mailing Address - Fax: | 620-235-7913 |
Practice Address - Street 1: | 1 MT. CARMEL WAY |
Practice Address - Street 2: | |
Practice Address - City: | PITTSBURG |
Practice Address - State: | KS |
Practice Address - Zip Code: | 66762-6643 |
Practice Address - Country: | US |
Practice Address - Phone: | 620-235-7995 |
Practice Address - Fax: | 620-235-7913 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2006-07-14 |
Last Update Date: | 2023-10-11 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 103T00000X | Behavioral Health & Social Service Providers | Psychologist | Group - Multi-Specialty | |
No | 133V00000X | Dietary & Nutritional Service Providers | Dietitian, Registered | Group - Multi-Specialty | |
No | 207L00000X | Allopathic & Osteopathic Physicians | Anesthesiology | Group - Multi-Specialty | |
No | 207P00000X | Allopathic & Osteopathic Physicians | Emergency Medicine | Group - Multi-Specialty | |
Yes | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty | |
No | 207RC0000X | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | Group - Multi-Specialty |
No | 207RH0003X | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology | Group - Multi-Specialty |
No | 207V00000X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Group - Multi-Specialty | |
No | 207ZP0102X | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology & Clinical Pathology | Group - Multi-Specialty |
No | 208100000X | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | Group - Multi-Specialty | |
No | 2084P0800X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry | Group - Multi-Specialty |
No | 208600000X | Allopathic & Osteopathic Physicians | Surgery | Group - Multi-Specialty | |
No | 363L00000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Group - Multi-Specialty | |
No | 363LX0106X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Occupational Health | Group - Multi-Specialty |
No | 367500000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered | Group - Multi-Specialty |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
KS | 014041 | Other | KANSAS |
KS | 100099300B | Medicaid | |
MO | 203406806 | Medicaid | |
MO | 4294 | Other | BCBS MISSOURI |
KS | 014041 | Medicare ID - Type Unspecified | PROFESSIONAL SERVICES |
MO | 4294 | Other | BCBS MISSOURI |