DR. KIMBERLY J PANKOW (NPI# 1265416499) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265416499 |
| Entity Type | Individual |
| Full Name | DR. KIMBERLY J PANKOW |
| Credential | MD |
| Practice Address |
5500 E Kellogg Dr Bh Wichita KS 67218-1607 |
| Practice Telephone | 3166513621 |
| Practice Fax Number | 3166343091 |
| Mailing Telephone | 3166513621 |
| Mailing Fax Number | 3166343091 |
| Enumeration Date | 2005-12-01 |
| Last Update Date | 2008-02-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
0420958 | KS | Allopathic & Osteopathic Physicians |
| Street Address |
5500 E KELLOGG DR BH |
| City | WICHITA |
| State | KS |
| Zip Code | 67218-1607 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194729673 | Catherine A Toomey | Physician Assistant | 5500 E Kellogg Dr, Wichita, KS 67218-1607 | 2005-06-13 |
| 1225642051 | Mark Clark | Pharmacist | 5500 E Kellogg Dr, Wichita, KS 67218-1607 | 2020-08-31 |
| 1598377483 | Rachel Elaine Donis | Occupational Therapist | 5500 E Kellogg Dr, Wichita, KS 67218-1607 | 2020-08-20 |
| 1164030060 | Jacob Michael Goeser | Optometrist | 5500 E Kellogg Dr, Wichita, KS 67218-1607 | 2020-07-16 |
| 1992329262 | Aimee Boriboun | Pharmacist | 5500 E Kellogg Dr, Wichita, KS 67218-1607 | 2020-06-02 |
| 1760012900 | Lisa Christy | Nurse Practitioner | 5500 E Kellogg Dr, Wichita, KS 67218-1607 | 2020-01-15 |
| 1790324499 | Linda Walim Nola | Pharmacist | 5500 E Kellogg Dr, Wichita, KS 67218-1607 | 2019-12-27 |
| 1164078010 | Daniel Steven Haley | Social Worker | 5500 E Kellogg Dr, Wichita, KS 67218-1607 | 2019-08-16 |
| 1790331783 | Jason Alan Jester | Social Worker | 5500 E Kellogg Dr, Wichita, KS 67218-1607 | 2019-08-15 |
| 1629624770 | Emily Suzanne Stuart | Social Worker | 5500 E Kellogg Dr, Wichita, KS 67218-1607 | 2019-08-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114544392 | Diana Ho | Optometrist | 980 Oliver Street, Wichita, KS 67218 | 2020-07-03 |
| 1134773690 | Lily Lopez | Nurse's Aide | 5107 E Kellogg Drive, Wichita, KS 67218 | 2019-08-01 |
| 1750862512 | Kelsi Wenger | Student in an Organized Health Care Education/Training Program | 5500 E Kellog Dr, Wichita, KS 67218 | 2018-08-28 |
| 1770038937 | Hair Replacement Clinic | Specialist | 1815 S Windsor, Wichita, KS 67218 | 2016-08-17 |
| 1457757346 | South Wind Women's Centter, LLC | Clinic/Center | 5701 E Kellogg Drive, Wichita, KS 67218 | 2014-11-05 |
| 1124460787 | Teri Kitchen | Social Worker | 3414 Kinkaid, Wichita, KS 67218 | 2013-07-24 |
| 1053660142 | Glenda Rodgers-lawless, Ph.d., Lcpc, Pa | Community/Behavioral Health | 4601 E Douglas, Wichita, KS 67218 | 2012-09-05 |
| 1649541848 | Stephen Rhinehart | Registered Nurse | 5500 E Kellogg Dr., Wichita, KS 67218 | 2012-01-19 |
| 1457666927 | Recovery Services Council Inc. | Point of Service | 1611 South Rutan, Wichita, KS 67218 | 2010-08-09 |
| 1043535867 | Melissa A Weinley | Respiratory Therapist, Registered | 5500 East Kellog Dr, Wichita, KS 67218 | 2010-04-05 |
| Find all providers in zip 67218 | ||||
| Taxonomy Code | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659633709 | Larry David Mitnaul Jr. | Psychiatry & Neurology | 1515 S Clifton Ave Ste 300, Wichita, KS 67218-2953 | 2012-06-14 |
| 1235344433 | Mathias James Lillig | Psychiatry & Neurology | 1001 N Minneapolis St, Wichita, KS 67214-3127 | 2007-05-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760652531 | Robert Seth Gordon | Psychiatry & Neurology | 611 S Kansas Ave Ste 101, Topeka, KS 66603 | 2008-03-07 |
| 1902945934 | Mwendalubi Yasa | Psychiatry & Neurology | 1901 East First Street, Prairie View, Newton, KS 67114-0467 | 2007-02-06 |
| 1871639799 | Kansas University Physicians Inc | Psychiatry & Neurology | 1088 Delp Pavilion, Mail Stop 4015 3901 Rainbow Blvd, Kansas City, KS 66160 | 2007-01-29 |
| 1306996434 | Poonam Khanna | Psychiatry & Neurology | 14221 Metcalf Ave, Suite 123, Overland Park, KS 66223-3344 | 2007-01-11 |
| 1225067655 | M David Brown | Psychiatry & Neurology | 8300 College Blvd Ste 320, Overland Park, KS 66210-2814 | 2006-06-30 |
| 1629510417 | Wexler Family Psychiatry | Psychiatry & Neurology | 4203 Booth St, Kansas City, KS 66103-3116 | 2016-11-09 |
| 1548680507 | Caitlin Mellencamp Winder | Psychiatry & Neurology | 8000 W 127th St, Overland Park, KS 66213-2714 | 2014-04-17 |
| 1821346495 | Stacey Allison Laird | Psychiatry & Neurology | 4121 W 83rd St, Suite 204, Prairie Village, KS 66208-5472 | 2012-08-29 |
| 1851646285 | Anthony Anunwa Md Pa | Psychiatry & Neurology | 1600 N Lorraine St, Hutchinson, KS 67501-5670 | 2012-07-23 |
| 1164784963 | Daniel J Tseng | Psychiatry & Neurology | 650 Huebner Rd, Fort Riley, KS 66442 | 2012-06-08 |
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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.