UKHS GREAT BEND, LLC
NPI 1073003992
Clinic/Center - Rural Health in Great Bend, KS

Active since May 16, 2018CLIA 17D0915738 · Microscopy
3515 BROADWAY AVE, GREAT BEND, KS 67530(620) 792-5341 Get Directions Write a Review

NPPES record last updated: September 18, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Mar 11, 2020, May 16, 2018 (2 updates tracked since 2018).

About Ukhs Great Bend, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

UKHS GREAT BEND, LLC (NPI 1073003992) is a healthcare organization registered as a rural health in Great Bend, Kansas and active in the NPI registry since May 2018. The organization holds a CLIA Microscopy certificate valid through August 28, 2027 and lists Jesse Mock, Authorized Official, as its authorized official.

NPPES Registry Identity

NPI1073003992
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NameUKHS GREAT BEND, LLC
Location Address3515 BROADWAY AVEGreat Bend, KS 67530-3633
Mailing Address3515 Broadway AveGreat Bend, KS 67530-3633 · (620) 792-5341
Organization SubpartNo
Authorized OfficialJesse MockAuthorized Official · (620) 791-6272
Enumeration DateMay 16, 2018
Last NPPES UpdateSeptember 18, 20232 updates tracked since enumeration
NPPES CertifiedSeptember 18, 2023
NPI 1073003992 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
3515 BROADWAY AVE, Great Bend, KS 67530

Accepted Insurance

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 17D0915738

Ukhs Great Bend LLC Dba Medical Pavilion · Great Bend, KS
Active · expires Aug 28, 2027
CLIA Number17D0915738
Laboratory TypeRural Health Clinic
Certificate Effective DateAugust 29, 2025
Certificate Expiration DateAugust 28, 2027
Laboratory DirectorJodi E. Henrikson
Laboratory Phone(620) 792-2151
Laboratory LocationUkhs Great Bend LLC Dba Medical Pavilion514 Cleveland Street, Great Bend, KS 67530
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

General Practice
3515 BROADWAY AVE
GREAT BEND, KS 67530
Durable Medical Equipment & Medical Supplies
3515 BROADWAY AVE
GREAT BEND, KS 67530
Family Medicine
3515 BROADWAY AVE
GREAT BEND, KS 67530
Nurse Anesthetist, Certified Registered
3515 BROADWAY AVE
GREAT BEND, KS 67530
Family Medicine
3515 BROADWAY AVE
GREAT BEND, KS 67530
Speech-Language Pathologist
3515 BROADWAY AVE
GREAT BEND, KS 67530
Occupational Therapy Assistant
3515 BROADWAY AVE
GREAT BEND, KS 67530
Nurse Practitioner
3515 BROADWAY AVE
GREAT BEND, KS 67530

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ukhs Great Bend, LLC's NPI number?

The NPI number for Ukhs Great Bend, LLC is 1073003992. It was assigned to this organization in the NPPES registry on May 16, 2018.

Where is Ukhs Great Bend, LLC located?

Ukhs Great Bend, LLC is located at 3515 Broadway Ave, Great Bend, KS 67530. The listed phone number is (620) 792-5341.

What is Ukhs Great Bend, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.

Does Ukhs Great Bend, LLC hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 17D0915738) is associated with this NPI, valid through August 28, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Ukhs Great Bend, LLC accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Home State Health, Ambetter from Sunflower Health Plan and Ambetter of Oklahoma and 2 other insurers list Ukhs Great Bend, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Ukhs Great Bend, LLC was last updated on September 18, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.