OrganizationActive
Prairie Band Potawatomi Nation
NPI 1245266410 · Federally Qualified Health Center (FQHC) · Mayetta, KS
Provider details
- NPI number
- 1245266410
- Entity type
- Organization
- Primary specialty
- Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Tiffany Lewis, Business Office Manager(785) 966-8282
Specialties & taxonomies
Ambulatory Health Care Facilities
- Health Service Clinic/Center261QH0100X
Ambulatory Health Care Facilities
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
11400 158th Rd
Mayetta, KS 66509-0249
Phone: (785) 966-8200
Fax: (785) 966-8393
Street-level locationGet directions
Mailing address
11400 158th Rd
Mayetta, KS 66509-0249
Other names (DBA / former)
- Doing business as
- Prairie Band Potawatomi Health Center
Registry dates
- Enumerated
- 2006-06-22
- Last updated
- 2022-07-21
- Certified
- 2022-06-01
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.