Provider Demographics
NPI:1386724995
Name:COUNTY OF CHEROKEE
Entity type:Organization
Organization Name:COUNTY OF CHEROKEE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:PEYTON
Authorized Official - Middle Name:DANELE
Authorized Official - Last Name:KESSLER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:620-429-3087
Mailing Address - Street 1:110 EAST WALNUT
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:KS
Mailing Address - Zip Code:66725-0107
Mailing Address - Country:US
Mailing Address - Phone:620-429-3087
Mailing Address - Fax:620-429-3623
Practice Address - Street 1:110 EAST WALNUT
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:KS
Practice Address - Zip Code:66725-0107
Practice Address - Country:US
Practice Address - Phone:620-429-3087
Practice Address - Fax:620-429-3623
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local
No251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100114930AMedicaid
KS100114930AMedicaid