ADVANCED MENS HEALTH, LLC (NPI# 1063873354) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063873354 |
| Entity Type | Organization |
| Organization Name | ADVANCED MENS HEALTH, LLC |
| Practice Address |
3460 N Ridge Road #90 Wichita KS 67205-1222 |
| Mailing Address |
241 N Hillside Wichita KS 67214-6627 |
| Practice Telephone | 3166899185 |
| Practice Fax Number | 3166162095 |
| Mailing Telephone | 3167769495 |
| Mailing Fax Number | 3166162095 |
| Enumeration Date | 2016-03-14 |
| Last Update Date | 2016-03-14 |
| Authorized Official Name | CLAY E LYDDANE (OWNER) |
| Authorized Official Telephone | 3167224725 |
| Authorized Official Credential | MD, PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 0435145 | KS | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KS | 200740730A | 05 |
| Street Address |
3460 N RIDGE ROAD #90 |
| City | WICHITA |
| State | KS |
| Zip Code | 67205-1222 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295211910 | Emily M Chastain | Dentist | 3213 N. Ridge Rd, Wichita, KS 67205 | 2018-07-16 |
| 1811415466 | Awaken Psychology LLC | Clinic/Center | 2552 N Maize Ct Suite 600, Wichita, KS 67205 | 2017-09-05 |
| 1962940288 | Moc Wichita LLC | Assisted Living Facility | 7057 W Village Circle, Wichita, KS 67205 | 2017-02-07 |
| 1003362732 | Moc Wichita, LLC | Assisted Living Facility | 7057 West Village Circle, Wichita, KS 67205 | 2016-09-01 |
| 1649637653 | Abigail Friend | Audiologist-Hearing Aid Fitter | 2558 Lake Way Circle, Wichita, KS 67205 | 2016-01-21 |
| 1134505399 | Myles Davidson | Dentist | 3510 N Ridge Rd Ste 500, Wichita, KS 67205 | 2015-08-10 |
| 1093121097 | The Eye Gallery, LLC | Optometrist | 3084 N. Maize Rd, Wichita, KS 67205 | 2014-07-10 |
| 1922428721 | Sam's West, Inc. | Technician/Technologist | 3084 N. Maize Road, Witchita, KS 67205 | 2014-04-18 |
| 1447693627 | Caryn Rana Landreth | Social Worker | 3114 N Brush Creek St, Wichita, KS 67205 | 2013-04-08 |
| 1902182686 | Return To Motion Medical | Durable Medical Equipment & Medical Supplies | 3221 N Ridge Port Circle, Wichita, KS 67205 | 2011-10-26 |
| Find all providers in zip 67205 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952708018 | William Schroeder Fargo | Specialist | 701 N. Emporia, Wichita, KS 67214 | 2014-12-04 |
| 1619317740 | Teresa M Vincent | Specialist | 12605 E Lincoln Ct, Wichita, KS 67207-7016 | 2013-07-03 |
| 1043563349 | South Wind Women's Center, LLC | Specialist | 5101 E Kellogg Dr, Wichita, KS 67218-1625 | 2012-10-24 |
| 1386923209 | Emotional Journey, LLC | Specialist | 2604 West 9th Street North, Suite 205, Wichita, KS 67203-4792 | 2011-08-09 |
| 1780981712 | Jessica Ostrye | Specialist | 1748 N Payne Ave, Wichita, KS 67203-2823 | 2011-02-28 |
| 1770888364 | Megan Camiell Young | Specialist | 2114 N 127th St E, Wichita, KS 67206-3003 | 2011-01-13 |
| 1730322736 | Advanced Wound Care & Plastic Surgery Center, LLC | Specialist | 902 N Hillside St, Wichita, KS 67214-3220 | 2009-04-07 |
| 1023277977 | Todd A. Brown, M.d., P.a. | Specialist | 1515 S Clifton Ave Ste 215, Wichita, KS 67218-2958 | 2008-06-05 |
| 1063583862 | Comprehensive Adult Medicine, Pa | Specialist | 1355 North West Street, Wichita, KS 67203-1303 | 2006-11-13 |
| 1801987359 | Kenneth L. Hull | Specialist | 4358 Spyglass Court, Wichita, KS 67226 | 2006-09-28 |
| Find all providers in WICHITA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.