PRAIRIE BAND POTAWATOMI HEALTH CENTER
NPI 1245266410
Clinic/Center - Federally Qualified Health Center (FQHC) in Mayetta, KS

Q: What is Prairie Band Potawatomi Nation's NPI number?

The NPI number for Prairie Band Potawatomi Nation is 1245266410. It was assigned to this organization in the NPPES registry on June 22, 2006. The provider is doing business as Prairie Band Potawatomi Health Center.

Q: What is Prairie Band Potawatomi Nation's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.

Active since June 22, 2006CLIA 17D0668588 · Accreditation

11400 158TH RD, MAYETTA, KS 66509(785) 966-8200(785) 966-8393 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 21, 2022, Jun 20, 2018, Jan 17, 2018 (3 updates tracked since 2018).

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About Prairie Band Potawatomi Health Center NPPES

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

PRAIRIE BAND POTAWATOMI HEALTH CENTER (NPI 1245266410) is a healthcare organization registered as a federally qualified health center (fqhc) in Mayetta, Kansas and active in the NPI registry since June 2006. The organization holds an CLIA Accreditation certificate valid through November 19, 2027 and lists Tiffany Lewis, Business Office Manager, as its authorized official.

NPPES Registry Identity

NPI1245266410

Entity TypeOrganization

Primary Taxonomy261QF0400X

Legal Business NamePRAIRIE BAND POTAWATOMI NATION

Location Address11400 158TH RDMayetta, KS 66509-0249

Mailing Address11400 158th RdMayetta, KS 66509-0249 · (785) 966-8200 · Fax (785) 966-8393

Phone(785) 966-8200

Fax(785) 966-8393

Organization SubpartNo

Authorized OfficialTiffany LewisBusiness Office Manager · (785) 966-8282

Enumeration DateJune 22, 2006

Last NPPES UpdateJuly 21, 20223 updates tracked since enumeration

NPPES CertifiedJune 1, 2022

✔ NPI 1245266410 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities

Taxonomy Code261QF0400X

Also ListedClinic/Center · Health ServiceTaxonomy 261QH0100X

11400 158TH RD, Mayetta, KS 66509

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Other Names 1

Doing Business AsPrairie Band Potawatomi Health Center

Other Identifiers 1

Medicaid200259300AKS

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter from Sunflower Health Plan, Ambetter Health and more.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 of Accreditation 17D0668588

Prairie Band Potawatomi Family Health Center · Mayetta, KS

Active · expires Nov 19, 2027

CLIA Number17D0668588

Laboratory TypeCommunity Clinic

Certificate Effective DateNovember 20, 2025

Certificate Expiration DateNovember 19, 2027

Laboratory DirectorMrs. Jessi R. Deters

Laboratory Phone(785) 966-8200

Laboratory LocationPrairie Band Potawatomi Family Health Center11400 158 Road (po Box 249), Mayetta, KS 66509

CLIA data matches this NPI record on: Phone

This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Other Providers at the Same Location NPPES 18

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

CHARLES G BEALS D.D.S

Dentist (General Practice)