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FORT SCOTT FAMILY MEDICINE
NPI 1255601944
Nurse Practitioner - Family in Fort Scott, KS

Active since January 11, 2012CLIA 17D0986178 · Microscopy
202 STATE ST, SUITE A, FORT SCOTT, KS 66701(620) 223-3950 Get Directions Write a Review

NPPES record last updated: August 1, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Fort Scott Family Medicine NPPES

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

FORT SCOTT FAMILY MEDICINE (NPI 1255601944) is a healthcare organization registered as a family in Fort Scott, Kansas and active in the NPI registry since January 2012. The organization holds a CLIA Microscopy certificate valid through May 8, 2027 and lists Ricky Kellenberger, Physician, as its authorized official.

NPPES Registry Identity

NPI1255601944
Entity TypeOrganization
Primary Taxonomy363LF0000X
Legal Business NameFORT SCOTT FAMILY MEDICINE
Location Address202 STATE ST, SUITE AFort Scott, KS 66701-2031
Mailing Address202 State St, Suite AFort Scott, KS 66701-2031 · (620) 223-3950
Phone(620) 223-3950
Organization SubpartNo
Authorized OfficialRicky KellenbergerPhysician · (620) 224-3511
Enumeration DateJanuary 11, 2012
Last NPPES UpdateAugust 1, 2012
✔ NPI 1255601944 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in KS · 53-75555-122
202 STATE ST, Fort Scott, KS 66701
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

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) 17D0986178

Fort Scott Family Medicine, PA · Fort Scott, KS
Active · expires May 8, 2027
CLIA Number17D0986178
Laboratory TypePhysician Office
Certificate Effective DateMay 9, 2025
Certificate Expiration DateMay 8, 2027
Laboratory DirectorRicky D. Kellenberger, Do
Laboratory Phone(620) 223-3950
Laboratory LocationFort Scott Family Medicine, PA202 State Street, Suite A, Fort Scott, KS 66701
CLIA data matches this NPI record on: Address Name Phone
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 4

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

BACK TO HEALTH WELLNESS CENTER INC
Chiropractor
202 STATE ST, SUITE B
FORT SCOTT, KS 66701
Bourbon County (620) 223-0570
RYAN LEWIS
Nurse Practitioner (Family)
202 STATE ST, STE A
FORT SCOTT, KS 66701
Bourbon County (417) 321-2845
FORT SCOTT FAMILY MEDICINE, P.A.
Family Medicine
202 STATE ST, SUITE A
FORT SCOTT, KS 66701
Bourbon County (620) 223-3950
DR. RICKY KELLENBERGER D.O
Family Medicine
202 STATE ST, SUITE A
FORT SCOTT, KS 66701
Bourbon County (620) 223-3950

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 Fort Scott Family Medicine's NPI number?

The NPI number for Fort Scott Family Medicine is 1255601944. It was assigned to this organization in the NPPES registry on January 11, 2012.

Where is Fort Scott Family Medicine located?

Fort Scott Family Medicine is located at 202 State St Suite A, Fort Scott, KS 66701. The listed phone number is (620) 223-3950.

What is Fort Scott Family Medicine's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Does Fort Scott Family Medicine hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 17D0986178) is associated with this NPI, valid through May 8, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Fort Scott Family Medicine was last updated on August 1, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.