| Ascension Medical Group Via Christi, Pa | |
|
3311 E Murdock St Wichita KS 67208 | |
| (316) 689-9135 | |
| (316) 689-9102 |
| Full Name | Ascension Medical Group Via Christi, Pa |
|---|---|
| Speciality | Clinic/Center |
| Location | 3311 E Murdock St, Wichita, Kansas |
| Authorized Official Name and Position | Suzann M Wright (DIRECTOR,PATIENT FINANCIAL SERVICES) |
| Authorized Official Contact | 3167191201 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ascension Medical Group Via Christi, Pa Po Box 2969 Wichita KS 67201-2969 Ph: (316) 268-5178 | Ascension Medical Group Via Christi, Pa 3311 E Murdock St Wichita KS 67208 Ph: (316) 689-9135 |
| NPI Number | 1063453991 |
|---|---|
| Provider Enumeration Date | 06/10/2006 |
| Last Update Date | 06/03/2019 |
| Medicare PECOS PAC ID | 2961314497 |
|---|---|
| Medicare Enrollment ID | O20031104000089 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063453991 | NPI | - | NPPES |
| CC8489 | Other | KS | MEDICARE RAILROAD |
| 003719 | Other | KS | BCBS |
| CC8488 | Other | KS | MEDICARE RAILROAD |
| 100080310A | Medicaid | KS | |
| 200726520I | Medicaid | KS | |
| CU0056 | Other | KS | MEDICARE RAILROAD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Rhea A Rogers |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1881699643 PECOS PAC ID: 6901701549 Enrollment ID: I20031205000275 |
| Provider Name | Noel C Sanchez |
|---|---|
| Provider Type | Practitioner - Colorectal Surgery (proctology) |
| Provider Identifiers | NPI Number: 1861437386 PECOS PAC ID: 8921904491 Enrollment ID: I20031208000609 |
| Provider Name | Charles R Green |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568499267 PECOS PAC ID: 7012803521 Enrollment ID: I20040223000882 |
| Provider Name | Stephen W Hawks |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477544666 PECOS PAC ID: 0042207854 Enrollment ID: I20040426001000 |
| Provider Name | Teresa M Craddock |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1811949241 PECOS PAC ID: 5890784243 Enrollment ID: I20040510001606 |
| Provider Name | Ranjini R Madhavan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578501474 PECOS PAC ID: 7618959552 Enrollment ID: I20040603000984 |
| Provider Name | Tammie Lynn Nelson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629005236 PECOS PAC ID: 5193709343 Enrollment ID: I20040615001284 |
| Provider Name | James C Degner |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1376526327 PECOS PAC ID: 6901886076 Enrollment ID: I20040721000557 |
| Provider Name | Suryakumar V Reddy |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1508849787 PECOS PAC ID: 3779475900 Enrollment ID: I20041027000663 |
| Provider Name | P David Margolis |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1619921855 PECOS PAC ID: 8325000763 Enrollment ID: I20041028000768 |
| Provider Name | Richard Adam Desplinter |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1659300150 PECOS PAC ID: 2062475270 Enrollment ID: I20041109000597 |
| Provider Name | Douglas P Lewis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558366641 PECOS PAC ID: 1456303106 Enrollment ID: I20050210000830 |
| Provider Name | Steven Richard Scheufler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447231428 PECOS PAC ID: 2062465404 Enrollment ID: I20050225000521 |
| Provider Name | Gerald E Niernberger |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417986894 PECOS PAC ID: 7315994191 Enrollment ID: I20050404000931 |
| Provider Name | Myra C Long |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023128535 PECOS PAC ID: 3577510007 Enrollment ID: I20050406000549 |
| Provider Name | William Ransom Kilgore |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1295770832 PECOS PAC ID: 6406803766 Enrollment ID: I20050407001165 |
| Provider Name | Norman S Koehn |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568492114 PECOS PAC ID: 6103863220 Enrollment ID: I20050411000846 |
| Provider Name | Randall S Regehr |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1215972724 PECOS PAC ID: 4385682533 Enrollment ID: I20050419001166 |
| Provider Name | Kevin C Hoppock |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710913074 PECOS PAC ID: 2163460908 Enrollment ID: I20050421000592 |
| Provider Name | Jerry G Gaston |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1356340178 PECOS PAC ID: 2365480118 Enrollment ID: I20050421000680 |
| Provider Name | Michael A Wilson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255340337 PECOS PAC ID: 8123066941 Enrollment ID: I20050421001325 |
| Provider Name | John L Shellito |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1720019151 PECOS PAC ID: 9032158217 Enrollment ID: I20050427000684 |
| Provider Name | Diana Crook |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679530760 PECOS PAC ID: 0446168546 Enrollment ID: I20050505000845 |
| Provider Name | James F Hesse |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578521993 PECOS PAC ID: 3870487309 Enrollment ID: I20050505000905 |
| Provider Name | Steven A Garner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710996640 PECOS PAC ID: 3173563129 Enrollment ID: I20050509000950 |
| Provider Name | Clifford S Depew |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1114038544 PECOS PAC ID: 0042253932 Enrollment ID: I20050601001081 |
| Provider Name | Bruce E Barclay |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043277999 PECOS PAC ID: 4284670332 Enrollment ID: I20050629000746 |
| Provider Name | Sheryl M Beard |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669468328 PECOS PAC ID: 0244266526 Enrollment ID: I20050711000089 |
| Provider Name | Brian Johnson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306803911 PECOS PAC ID: 2163458845 Enrollment ID: I20050713001184 |
| Provider Name | Michael D Grimes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972569028 PECOS PAC ID: 5698701373 Enrollment ID: I20050713001190 |
| Provider Name | Dennis G Phillips |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275590887 PECOS PAC ID: 8426084849 Enrollment ID: I20050715000955 |
| Provider Name | Scott M Hane |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780611442 PECOS PAC ID: 4587692025 Enrollment ID: I20050727000300 |
| Provider Name | Matthew Todd Voth |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1679583033 PECOS PAC ID: 2961433768 Enrollment ID: I20050822000837 |
| Provider Name | Andrea B Mccarty |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063470938 PECOS PAC ID: 9830121805 Enrollment ID: I20050910000095 |
| Provider Name | Terri A Nickel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902867831 PECOS PAC ID: 5698708659 Enrollment ID: I20050912000592 |
| Provider Name | Dan E Mccarty |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780641613 PECOS PAC ID: 9133152119 Enrollment ID: I20050912000797 |
| Provider Name | Samuel E Heck |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346207370 PECOS PAC ID: 4789659897 Enrollment ID: I20050912000834 |
| Provider Name | Michael Wolfe |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1821008285 PECOS PAC ID: 0749209823 Enrollment ID: I20051117000618 |
| Provider Name | Shana Jarmer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699842799 PECOS PAC ID: 5698784288 Enrollment ID: I20060410000385 |
| Provider Name | Brooke B Grizzell |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1720099781 PECOS PAC ID: 6204830052 Enrollment ID: I20060908000362 |
| Provider Name | Elizabeth D Cox |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1316956493 PECOS PAC ID: 4587660485 Enrollment ID: I20061017000461 |
| Provider Name | Arian A Riordan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780765438 PECOS PAC ID: 3779581269 Enrollment ID: I20061116000385 |
| Provider Name | Leah A Brantley |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1275696130 PECOS PAC ID: 4284634783 Enrollment ID: I20070108000122 |
| Provider Name | Jill A Augustine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548399751 PECOS PAC ID: 0547363160 Enrollment ID: I20070319000570 |
| Provider Name | Richa Sharma |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669408480 PECOS PAC ID: 8123129509 Enrollment ID: I20070730000395 |
| Provider Name | Mayssa N Zayat |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1114120466 PECOS PAC ID: 2961595392 Enrollment ID: I20070830000615 |
| Provider Name | Valerie A Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952500340 PECOS PAC ID: 8022102888 Enrollment ID: I20070924000635 |
| Provider Name | Mary C Le |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1790907228 PECOS PAC ID: 3476636267 Enrollment ID: I20080218000295 |
| Provider Name | Sheryll E Clarke |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1548444219 PECOS PAC ID: 5890877112 Enrollment ID: I20080414000011 |
| Provider Name | Janey E Maki |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1205859030 PECOS PAC ID: 2365412657 Enrollment ID: I20080510000018 |
| Provider Name | Lei Liu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851378616 PECOS PAC ID: 3476510256 Enrollment ID: I20080904000154 |
| Provider Name | Nancy M Terry |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1083755573 PECOS PAC ID: 5991873986 Enrollment ID: I20081003000364 |
| Provider Name | Nse Renee Nkana |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073736039 PECOS PAC ID: 6204904105 Enrollment ID: I20081006000184 |
| Provider Name | Romeo Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619027554 PECOS PAC ID: 2567453798 Enrollment ID: I20081007000708 |
| Provider Name | Lacie L Gregory |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124223649 PECOS PAC ID: 0244391456 Enrollment ID: I20081205000807 |
| Provider Name | Stacy R Allenbach |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1093951170 PECOS PAC ID: 8325102619 Enrollment ID: I20090202000173 |
| Provider Name | Kristin T Galan |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1245422963 PECOS PAC ID: 5092880765 Enrollment ID: I20090709000247 |
| Provider Name | Denise R Huskey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376760108 PECOS PAC ID: 1850437781 Enrollment ID: I20091007000491 |
| Provider Name | Terri D Walton |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447269618 PECOS PAC ID: 5496899536 Enrollment ID: I20100212000526 |
| Provider Name | Arthur F Windholz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285691790 PECOS PAC ID: 0244365591 Enrollment ID: I20100312000077 |
| Provider Name | Rosalie R Focken |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205862356 PECOS PAC ID: 1052448123 Enrollment ID: I20100421000431 |
| Provider Name | Charla L Yassine |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1275542359 PECOS PAC ID: 1850428525 Enrollment ID: I20100429000033 |
| Provider Name | Ragnar S Peterson |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1598706525 PECOS PAC ID: 4688679756 Enrollment ID: I20100504000038 |
| Provider Name | Miki Matsuda |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1720241821 PECOS PAC ID: 6305990243 Enrollment ID: I20100716000291 |
| Provider Name | Lana N Hattar |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1437368263 PECOS PAC ID: 9234262882 Enrollment ID: I20100803000285 |
| Provider Name | Kurt M Hesse |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528026960 PECOS PAC ID: 0143114678 Enrollment ID: I20110608000721 |
| Provider Name | Nadia Gibson |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1164698593 PECOS PAC ID: 8729152574 Enrollment ID: I20110725000467 |
| Provider Name | Kyle B Vincent |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1093964736 PECOS PAC ID: 9032387600 Enrollment ID: I20110726000510 |
| Provider Name | Clay E Lyddane |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1760641476 PECOS PAC ID: 6901074459 Enrollment ID: I20110727000616 |
| Provider Name | Andrea M Fullerton |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1063617587 PECOS PAC ID: 1456522309 Enrollment ID: I20110926000304 |
| Provider Name | Preethi C Kurakula |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1598942328 PECOS PAC ID: 0143495788 Enrollment ID: I20111209000794 |
| Provider Name | Debra D Carr |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1114203205 PECOS PAC ID: 5890961551 Enrollment ID: I20111229000538 |
| Provider Name | J Elizabeth Heflin |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1124063755 PECOS PAC ID: 9739390428 Enrollment ID: I20120119000851 |
| Provider Name | Naomi L Berends |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689954026 PECOS PAC ID: 7113189960 Enrollment ID: I20120424000542 |
| Provider Name | Randy J Eilert |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1760649685 PECOS PAC ID: 0042476749 Enrollment ID: I20120725000089 |
| Provider Name | Sara E Purdy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528292208 PECOS PAC ID: 5193997070 Enrollment ID: I20120905000309 |
| Provider Name | Jenna L Loomis |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1063763985 PECOS PAC ID: 4183874829 Enrollment ID: I20121015000738 |
| Provider Name | Johnna S Costello |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184968133 PECOS PAC ID: 6608029814 Enrollment ID: I20130118000261 |
| Provider Name | Marci L Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568714533 PECOS PAC ID: 6608021811 Enrollment ID: I20130219000169 |
| Provider Name | Moneeshindra S Mittal |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1255591442 PECOS PAC ID: 3870748254 Enrollment ID: I20130311000228 |
| Provider Name | Yu Hong Kahnert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093054314 PECOS PAC ID: 1153566575 Enrollment ID: I20130405000253 |
| Provider Name | Khalida Mahdi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609063312 PECOS PAC ID: 1052557782 Enrollment ID: I20130424000797 |
| Provider Name | Tara Lee Katz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386962215 PECOS PAC ID: 7315199825 Enrollment ID: I20130717000119 |
| Provider Name | Adam M Goodwin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376854059 PECOS PAC ID: 4981728037 Enrollment ID: I20130920000019 |
| Provider Name | Claudia A Lovings |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1730459330 PECOS PAC ID: 1153555321 Enrollment ID: I20131002000364 |
| Provider Name | Molly K Pierce |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1104151190 PECOS PAC ID: 4688808850 Enrollment ID: I20131002000395 |
| Provider Name | David P Timler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154641025 PECOS PAC ID: 6709033459 Enrollment ID: I20131009001562 |
| Provider Name | Christine E Stearman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740613462 PECOS PAC ID: 5193951531 Enrollment ID: I20131113001656 |
| Provider Name | Nichole M Riddel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134430853 PECOS PAC ID: 6305073008 Enrollment ID: I20131227001329 |
| Provider Name | Philip Newlin |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1124055942 PECOS PAC ID: 8022127596 Enrollment ID: I20140102001464 |
| Provider Name | Abby M Mercado |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669807103 PECOS PAC ID: 2769611359 Enrollment ID: I20140130001179 |
| Provider Name | Saritha Gorantla |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1538416318 PECOS PAC ID: 3678796448 Enrollment ID: I20140523000516 |
| Provider Name | Abdel-ghanie H Abu-samra |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1134383177 PECOS PAC ID: 0840415493 Enrollment ID: I20140715002032 |
| Provider Name | Jihane J Sfeir |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215236815 PECOS PAC ID: 5597912485 Enrollment ID: I20140822000336 |
| Provider Name | James M Frogge |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1023064235 PECOS PAC ID: 3274680863 Enrollment ID: I20140923000971 |
| Provider Name | Jennifer R Pyles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326447129 PECOS PAC ID: 8820219413 Enrollment ID: I20141023002165 |
| Provider Name | Ashley Michelle Corkill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740683911 PECOS PAC ID: 9032331509 Enrollment ID: I20141118000724 |
| Provider Name | Shean Robert Mcknight |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1740577824 PECOS PAC ID: 2062669716 Enrollment ID: I20150302000692 |
| Provider Name | Ali M Elkharbotly |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1710147780 PECOS PAC ID: 3678884145 Enrollment ID: I20150624002625 |
| Provider Name | Surendra B Kolla |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1194952143 PECOS PAC ID: 5597086819 Enrollment ID: I20150626001035 |
| Provider Name | Pedro W Vivar Cruz |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1891007746 PECOS PAC ID: 5799097028 Enrollment ID: I20150630000454 |
| Provider Name | Mitchell D Flurry |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1528225166 PECOS PAC ID: 0143443184 Enrollment ID: I20150630002779 |
| Provider Name | Andre Saad |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1124259213 PECOS PAC ID: 8921310426 Enrollment ID: I20150710001652 |
| Provider Name | Ricky W Lee |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1932357571 PECOS PAC ID: 1658540539 Enrollment ID: I20150720000060 |
| Provider Name | Dennis O Oyieng'o |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1629207766 PECOS PAC ID: 6608095781 Enrollment ID: I20150722004360 |
| Provider Name | Gabrielle Teresa Guhl |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578824454 PECOS PAC ID: 8325299589 Enrollment ID: I20150728005231 |
| Provider Name | Shaunda M Rodriguez |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1932356078 PECOS PAC ID: 2860642618 Enrollment ID: I20150730010812 |
| Provider Name | Adam D Keesling |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881956001 PECOS PAC ID: 2163672783 Enrollment ID: I20150730013771 |
| Provider Name | Kevin Kadesky |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1295818631 PECOS PAC ID: 1456394519 Enrollment ID: I20150828000450 |
| Provider Name | Alicia M Reeves |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639548738 PECOS PAC ID: 1052629268 Enrollment ID: I20151007001313 |
| Provider Name | Youssef S Yammine |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1295957587 PECOS PAC ID: 3870787609 Enrollment ID: I20151106001982 |
| Provider Name | Sheri L Crummey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417097643 PECOS PAC ID: 5294829305 Enrollment ID: I20160129001768 |
| Provider Name | Tressie R Maugans |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639544992 PECOS PAC ID: 9032413638 Enrollment ID: I20160202000898 |
| Provider Name | Rafael E Cabrera Salinas |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1013145747 PECOS PAC ID: 2466684295 Enrollment ID: I20160519001885 |
| Provider Name | Bala Bhaskar Reddy Bhimavarapu |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1699111484 PECOS PAC ID: 4688970932 Enrollment ID: I20160520002055 |
| Provider Name | Raid A Abu-awwad |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1386945392 PECOS PAC ID: 4789973207 Enrollment ID: I20160523000744 |
| Provider Name | Jessica L Marean |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124477245 PECOS PAC ID: 2466743083 Enrollment ID: I20160628002698 |
| Provider Name | Vu Thu T Nguyen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861838245 PECOS PAC ID: 4082855788 Enrollment ID: I20160728000897 |
| Provider Name | Hugh P Wong |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1316206691 PECOS PAC ID: 0941433932 Enrollment ID: I20160902001770 |
| Provider Name | Walter K Kalu |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942646252 PECOS PAC ID: 8022252477 Enrollment ID: I20160921002031 |
| Provider Name | Jennifer R Callison |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316383771 PECOS PAC ID: 3577706555 Enrollment ID: I20160927001149 |
| Provider Name | Racquel A Sanchez |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1124389564 PECOS PAC ID: 9032349337 Enrollment ID: I20160929000300 |
| Provider Name | Kelsey E Barnickle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649728254 PECOS PAC ID: 6901194059 Enrollment ID: I20161005002678 |
| Provider Name | Kelli A Rice |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881144376 PECOS PAC ID: 6507144078 Enrollment ID: I20161103002068 |
| Provider Name | Umber Z Khan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1275764953 PECOS PAC ID: 9537303805 Enrollment ID: I20170109001448 |
| Provider Name | Brian J Goentzel |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1194959692 PECOS PAC ID: 6305086950 Enrollment ID: I20170509002891 |
| Provider Name | Christopher R Halphen |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1255695672 PECOS PAC ID: 7911299573 Enrollment ID: I20170705001057 |
| Provider Name | Jonathan D Scrafford |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1639411325 PECOS PAC ID: 3870898117 Enrollment ID: I20170720000507 |
| Provider Name | Larry David Mitnaul |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659633709 PECOS PAC ID: 9335430867 Enrollment ID: I20170802000572 |
| Provider Name | Lauren M Cote |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801314745 PECOS PAC ID: 7618233347 Enrollment ID: I20171113000739 |
| Provider Name | Cooper N Stewart |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699123901 PECOS PAC ID: 1951695683 Enrollment ID: I20180319002873 |
| Provider Name | Aaron Scott Thiessen |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1043659527 PECOS PAC ID: 7618103003 Enrollment ID: I20180406000146 |
| Provider Name | Emily A O'dell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083095970 PECOS PAC ID: 7315251402 Enrollment ID: I20180501001756 |
| Provider Name | Simon P Patton |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1497042444 PECOS PAC ID: 7911127410 Enrollment ID: I20180713001667 |
| Provider Name | Allison Dick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013403039 PECOS PAC ID: 6608125778 Enrollment ID: I20180822002888 |
| Provider Name | Danica Rae Wheeler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588072557 PECOS PAC ID: 2769736800 Enrollment ID: I20181108001568 |
| Provider Name | Karissa A Gilchrist |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558890384 PECOS PAC ID: 8921379298 Enrollment ID: I20181114002195 |
| Provider Name | Nichole L Fischer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629552484 PECOS PAC ID: 9133473572 Enrollment ID: I20181121000750 |
| Provider Name | Joshua Mccoy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659720084 PECOS PAC ID: 2567755440 Enrollment ID: I20181205002271 |
| Provider Name | Serina Jo Hertel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851816433 PECOS PAC ID: 8628314341 Enrollment ID: I20190116002163 |
| Provider Name | Kimberly A Burtch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407311178 PECOS PAC ID: 1759622954 Enrollment ID: I20190417001110 |
| Provider Name | Selia Y Whitney |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275982266 PECOS PAC ID: 7012201759 Enrollment ID: I20190418001323 |
| Provider Name | Kathryn Henecke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598206435 PECOS PAC ID: 1759659840 Enrollment ID: I20190711001387 |
| Provider Name | Kirsten A Bjorkman |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1669821799 PECOS PAC ID: 4789978438 Enrollment ID: I20190730002641 |
| Provider Name | Lauria I Haury |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477108603 PECOS PAC ID: 8729316112 Enrollment ID: I20190822003274 |
| Provider Name | Andrea M Rogers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083262695 PECOS PAC ID: 4587096615 Enrollment ID: I20191112000536 |
| Provider Name | Edward N Digges |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1093731150 PECOS PAC ID: 3577509207 Enrollment ID: I20200124000760 |
| Provider Name | Jared M Regehr |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295228609 PECOS PAC ID: 9739438144 Enrollment ID: I20200212000300 |
| Provider Name | Shayna N Dallas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962979732 PECOS PAC ID: 4284988742 Enrollment ID: I20200505001461 |
| Provider Name | Ignacio Agustin De Cicco |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1770998973 PECOS PAC ID: 7810266954 Enrollment ID: I20200520000737 |
| Provider Name | Krystal L Mitchell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356956890 PECOS PAC ID: 6305265570 Enrollment ID: I20201007003305 |
| Provider Name | Judith Anne Shilling |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497355473 PECOS PAC ID: 3375950033 Enrollment ID: I20210324001639 |
| Provider Name | Megan L Silvers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669058921 PECOS PAC ID: 0244647436 Enrollment ID: I20210406001775 |
| Provider Name | Alexandra J Meloccaro |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1366971145 PECOS PAC ID: 3173894409 Enrollment ID: I20210428001318 |
| Provider Name | Rachel R Mendoza |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265092647 PECOS PAC ID: 4880920537 Enrollment ID: I20210506002113 |
| Provider Name | Shamara Mae Burrow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053990903 PECOS PAC ID: 9931508520 Enrollment ID: I20210602001434 |
| Provider Name | Mohamad El Zein |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1861874455 PECOS PAC ID: 1153626833 Enrollment ID: I20210614002007 |
| Provider Name | Ibrahim J Raphael |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1275943144 PECOS PAC ID: 6406158948 Enrollment ID: I20210709001750 |
| Provider Name | Whitney W Rowe |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588046148 PECOS PAC ID: 9931413028 Enrollment ID: I20210723001601 |
| Provider Name | Carla Burford |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1336677392 PECOS PAC ID: 3971874298 Enrollment ID: I20210729001810 |
| Provider Name | Jennifer Wagner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083387757 PECOS PAC ID: 7719383603 Enrollment ID: I20210831003572 |
| Provider Name | Karly Brianne White |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1649842642 PECOS PAC ID: 0648676817 Enrollment ID: I20210914001138 |
| Provider Name | Kay R Hocutt |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1023027125 PECOS PAC ID: 8325157894 Enrollment ID: I20211006002857 |
| Provider Name | Vanessa T Nguyen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073272464 PECOS PAC ID: 9032501101 Enrollment ID: I20220121002428 |
| Provider Name | Laura Tambling |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295371482 PECOS PAC ID: 2961894977 Enrollment ID: I20220125003060 |
| Provider Name | Cassie N Bieker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568123511 PECOS PAC ID: 0244623973 Enrollment ID: I20220202000211 |
| Provider Name | Sarah Zimmerman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629738703 PECOS PAC ID: 7214321355 Enrollment ID: I20220307000478 |
| Provider Name | Rachelle E Poirier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821741919 PECOS PAC ID: 8527454230 Enrollment ID: I20220406000821 |
| Provider Name | Sarah E Swank |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851039705 PECOS PAC ID: 7416335088 Enrollment ID: I20220610000264 |
| Provider Name | Thao Thi Ngoc Nguyen |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1972957488 PECOS PAC ID: 9234421520 Enrollment ID: I20220721000750 |
| Provider Name | Laura M Birkholtz |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1992298343 PECOS PAC ID: 2961751409 Enrollment ID: I20220804003739 |
| Provider Name | Susan Stevens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770218596 PECOS PAC ID: 5698159069 Enrollment ID: I20220902001099 |
| Provider Name | Hannah M Scoville |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457919680 PECOS PAC ID: 1759617483 Enrollment ID: I20220929001619 |
| Provider Name | Amber Michelle Kamalei Sudduth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871217018 PECOS PAC ID: 6305222803 Enrollment ID: I20221006003060 |
| Provider Name | Kevin W Klug |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124657838 PECOS PAC ID: 0345663449 Enrollment ID: I20221104000264 |
| Provider Name | Juan P Mendez |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1659095958 PECOS PAC ID: 1850769480 Enrollment ID: I20221201001916 |
| Provider Name | Holly Stein |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134701394 PECOS PAC ID: 0446620827 Enrollment ID: I20221229000299 |
| Provider Name | Travis J Kasper |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285208520 PECOS PAC ID: 0345644787 Enrollment ID: I20230331001366 |
| Provider Name | Whitney L Lohkamp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912607425 PECOS PAC ID: 7214392174 Enrollment ID: I20230427001644 |
| Provider Name | Kelly A Winter |
|---|---|
| Provider Type | Practitioner - Colorectal Surgery (proctology) |
| Provider Identifiers | NPI Number: 1790214179 PECOS PAC ID: 9335410406 Enrollment ID: I20230522000126 |
| Provider Name | Brynn C Arnold |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932776762 PECOS PAC ID: 4789088808 Enrollment ID: I20230715000178 |
| Provider Name | Edward Nola |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841812229 PECOS PAC ID: 2163848243 Enrollment ID: I20231101002128 |
| Provider Name | Tyler A Laubach |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285201186 PECOS PAC ID: 4981008315 Enrollment ID: I20240206002569 |
| Provider Name | Brenda C Arce |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124889571 PECOS PAC ID: 8729423421 Enrollment ID: I20240305000342 |
Primary Care Associates, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 7111 E 21st St N Ste A, Wichita, KS 67206 Phone: 316-684-2851 | |
Substance Abuse At Hunter Health Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2318 E Central Ave, Wichita, KS 67214 Phone: 316-262-3611 Fax: 316-262-0741 | |
Freestate Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4723 E Douglas Ave, Wichita, KS 67218 Phone: 888-505-1776 Fax: 888-505-1776 | |
Robert A Sweet Md Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3122 N Cypress Dr, Suite 100, Wichita, KS 67226 Phone: 316-260-4747 | |
World Impact, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3701 E 13th St N, #400, Wichita, KS 67208 Phone: 316-682-1880 | |
The Traveling Np Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 826 N Bracken Cir, Wichita, KS 67206 Phone: 316-990-8848 | |
Healthcore Clinic Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2707 East 21st Street North, Wichita, KS 67214 Phone: 316-691-0249 Fax: 316-691-9939 |