| Minor Med PA | |
|
1119 Sw Gage Blvd Topeka KS 66604-1999 | |
| (785) 272-4000 | |
| (785) 272-0894 |
| Full Name | Minor Med PA |
|---|---|
| Speciality | Clinic/Center |
| Location | 1119 Sw Gage Blvd, Topeka, Kansas |
| Authorized Official Name and Position | Steve Iliff (BUSINESS MANAGER) |
| Authorized Official Contact | 7852724000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Minor Med PA 1119 Sw Gage Blvd Topeka KS 66604-1999 Ph: (785) 272-4000 | Minor Med PA 1119 Sw Gage Blvd Topeka KS 66604-1999 Ph: (785) 272-4000 |
| NPI Number | 1093827511 |
|---|---|
| Provider Enumeration Date | 08/31/2006 |
| Last Update Date | 07/29/2019 |
| Medicare PECOS PAC ID | 6709897580 |
|---|---|
| Medicare Enrollment ID | O20190912001027 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093827511 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | () | Primary |
| Provider Name | Gary G Graf |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053482174 PECOS PAC ID: 3870584311 Enrollment ID: I20040521001185 |
| Provider Name | Lucinda J Schneider |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780735936 PECOS PAC ID: 6002911526 Enrollment ID: I20070411000479 |
| Provider Name | Richard Douglas Iliff |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184692386 PECOS PAC ID: 5092874362 Enrollment ID: I20081103000082 |
| Provider Name | Roger M Gibson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083681043 PECOS PAC ID: 1850439498 Enrollment ID: I20091119000070 |
| Provider Name | Nancy J Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023195849 PECOS PAC ID: 3375685969 Enrollment ID: I20100120000296 |
| Provider Name | Jill S Collins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336487412 PECOS PAC ID: 6608012802 Enrollment ID: I20130412000494 |
| Provider Name | Kristin K Poage |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811329774 PECOS PAC ID: 7113154311 Enrollment ID: I20131213001554 |
| Provider Name | Nicole Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336533025 PECOS PAC ID: 6204141567 Enrollment ID: I20150814013971 |
| Provider Name | Lori R Peltier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629487996 PECOS PAC ID: 5799072088 Enrollment ID: I20160930000473 |
| Provider Name | Danielle L Balthazor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154851186 PECOS PAC ID: 1951670736 Enrollment ID: I20170711000981 |
| Provider Name | Laura Marbun |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548718935 PECOS PAC ID: 9830462795 Enrollment ID: I20170829002421 |
| Provider Name | Kaylie D Zimmerman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790207207 PECOS PAC ID: 5395004485 Enrollment ID: I20180118000155 |
| Provider Name | Jennifer Warren |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821659061 PECOS PAC ID: 9234464025 Enrollment ID: I20190716003324 |
| Provider Name | Scott P Ford |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1205921244 PECOS PAC ID: 3779811898 Enrollment ID: I20190827001735 |
| Provider Name | Matthew M Yates |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1538157540 PECOS PAC ID: 3678907896 Enrollment ID: I20191221000538 |
| Provider Name | Christopher F Stubbs |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942645478 PECOS PAC ID: 8820305394 Enrollment ID: I20210812003678 |
| Provider Name | Blaire Elyse Helgeson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629685284 PECOS PAC ID: 1658761127 Enrollment ID: I20211124001866 |
| Provider Name | Ashley a Broxterman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609464304 PECOS PAC ID: 5092108431 Enrollment ID: I20220208002445 |
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