{"npi":"1033218565","type":"NPI-2","status":"active","name":{"display":"Healthcore Clinic INC","other":[],"organization_name":"HEALTHCORE CLINIC INC","authorised_official":"Teresa Lovelady"},"specialty":{"primary_taxonomy":"261QF0400X","primary_taxonomy_description":"Federally Qualified Health Center","slug":"fqhc","schema_org_specialty":"PrimaryCare","all":[{"code":"261QR0405X","description":"Substance Use Disorder Rehabilitation Clinic/Center","primary":false,"state":"KS","license":"07000882"},{"code":"261QM0801X","description":"Mental Health Clinic/Center (Including Community Mental Health Center)","primary":false,"state":"KS","license":"07000887"},{"code":"261QF0400X","description":"Federally Qualified Health Center","primary":true,"state":"KS","license":"1033218565"}]},"addresses":[{"purpose":"LOCATION","street_1":"2707 EAST 21ST STREET NORTH","city":"WICHITA","state":"KS","postal_code":"672142249","country_code":"US","phone":"3166910249","fax":"3166919939"},{"purpose":"MAILING","street_1":"2707 EAST 21ST STREET NORTH","city":"WICHITA","state":"KS","postal_code":"672142249","country_code":"US","phone":"3166910249","fax":"3166919939"}],"license":{"state":"KS","number":"1033218565"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"100321990","state":"KS","issuer":null},{"type_code":"05","label":"Medicaid","value":"100321990C","state":"KS","issuer":null},{"type_code":"05","label":"Medicaid","value":"100321990A","state":"KS","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20031111000669","type_code":"12-70","type_desc":"PART B SUPPLIER - CLINIC/GROUP PRACTICE","state":"KS","pac_id":"9739092131"},{"enrlmt_id":"O20090702000064","type_code":"00-04","type_desc":"PART A PROVIDER - FEDERALLY QUALIFIED HEALTH CENTER (FQHC)","state":"KS","pac_id":"9739092131"}]},"enumeration_date":"2006-09-21","last_updated":"2015-08-14","_meta":{"source":"NPPES","snapshot_date":"2015-08-14","doc_url":"https://findmynpi.com/api"}}