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GREAT BEND CHILDRENS CLINIC PA
NPI 1619955853
Clinic/Center - Rural Health in Great Bend, KS

Active since January 06, 2006CLIA 17D0667345 · Waiver
1021 EISENHOWER AVE, GREAT BEND CHILDREN'S CLINIC, GREAT BEND, KS 67530(620) 792-5437(620) 793-5245 Get Directions Write a Review

NPPES record last updated: October 12, 2010. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Great Bend Childrens Clinic Pa NPPES

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

GREAT BEND CHILDRENS CLINIC PA (NPI 1619955853) is a healthcare organization registered as a rural health in Great Bend, Kansas and active in the NPI registry since January 2006. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists John T. Edmonds, Practice Administrator, as its authorized official.

NPPES Registry Identity

NPI1619955853
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NameGREAT BEND CHILDRENS CLINIC PA
Location Address1021 EISENHOWER AVE, GREAT BEND CHILDREN'S CLINICGreat Bend, KS 67530-3213
Mailing Address1021 Eisenhower Ave, Great Bend Children's ClinicGreat Bend, KS 67530-3213 · (620) 792-5437 · Fax (620) 793-5245
Phone(620) 792-5437
Fax(620) 793-5245
Organization SubpartNo
Authorized OfficialJohn T. EdmondsPractice Administrator · (620) 792-5437
Enumeration DateJanuary 6, 2006
Last NPPES UpdateOctober 12, 2010
✔ NPI 1619955853 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
1021 EISENHOWER AVE, Great Bend, KS 67530
Open in Google Maps ↗

Other Identifiers 3

Other016773KS · Bcbs Group No
Medicaid100299730AKS
Medicaid100127410BKS

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include UnitedHealthcare.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 Waiver 17D0667345

Great Bend Children's Clinic · Great Bend, KS
Active · expires Aug 31, 2026
CLIA Number17D0667345
Laboratory TypeRural Health Clinic
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorRyan M. Williams
Laboratory Phone(620) 792-5437
Laboratory LocationGreat Bend Children's Clinic1021 Eisenhower, Great Bend, KS 67530
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 8

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

DR. CHRISTOPHER JOSEPH KOSTER MD
Pediatrics
1021 EISENHOWER AVE
GREAT BEND, KS 67530
Barton County (620) 792-5437
MRS. JACQUELYN RENE FORSSBERG APRN
Nurse Practitioner (Women's Health)
1021 EISENHOWER AVE
GREAT BEND, KS 67530
Barton County (620) 792-5437
RUBI SPRAY APRN, FNP-BC
Nurse Practitioner (Family)
1021 EISENHOWER AVE
GREAT BEND, KS 67530
Barton County (620) 792-5437
MARLEY PALMER
Nurse Practitioner
1021 EISENHOWER AVE
GREAT BEND, KS 67530
Barton County (620) 792-5437
UKHS GREAT BEND, LLC
Clinic/Center (Rural Health)
1021 EISENHOWER AVE
GREAT BEND, KS 67530
Barton County (620) 792-2511
DIANNA HOLGUIN
Nurse Practitioner (Family)
1021 EISENHOWER AVE
GREAT BEND, KS 67530
Barton County (620) 792-5437
MARTA J EDMONDS M.D.
Pediatrics
1021 EISENHOWER AVE, GREAT BEND CHILDREN'S CLINIC, P.A.
GREAT BEND, KS 67530
Barton County (620) 792-5437
SUSAN J BAUER ARNP
Nurse Practitioner (Pediatrics)
1021 EISENHOWER AVE, GREAT BEND CHILDREN'S CLINIC
GREAT BEND, KS 67530
Barton County (620) 792-5848

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 Great Bend Childrens Clinic PA's NPI number?

The NPI number for Great Bend Childrens Clinic PA is 1619955853. It was assigned to this organization in the NPPES registry on January 6, 2006.

Where is Great Bend Childrens Clinic PA located?

Great Bend Childrens Clinic PA is located at 1021 Eisenhower Ave Great Bend Children's Clinic, Great Bend, KS 67530. The listed phone number is (620) 792-5437.

What is Great Bend Childrens Clinic PA's specialty?

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

Does Great Bend Childrens Clinic PA hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 17D0667345) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Great Bend Childrens Clinic PA accept?

Health plans from UnitedHealthcare list Great Bend Childrens Clinic PA 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 Great Bend Childrens Clinic PA was last updated on October 12, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.