BOB BORN (NPI# 1295775138) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1295775138 |
Entity Type | Individual |
Full Name | BOB BORN |
Credential | APRN |
Practice Address |
1421 E 2nd St N Wichita KS 67214-4119 |
Practice Telephone | 3163030333 |
Practice Fax Number | 3168477093 |
Mailing Telephone | 3163030333 |
Mailing Fax Number | 3168477093 |
Enumeration Date | 2006-06-08 |
Last Update Date | 2018-03-17 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 163WP0808X |
Registered Nurse Specialization: Psych/Mental Health |
14-78962-091 | KS | Nursing Service Providers |
Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
74595 | KS | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
KS | BLUE CROSS BLUE SHIELD | 160849 | 01 |
KS | PREFERRED HEALTH SYSTEMS | 14563 | 01 |
KS | CIGNA | 2144767 | 01 |
KS | RAILROAD MEDICARE | 500029366 | 01 |
Address | Telephone Number | Fax Number |
---|---|---|
1919 N Amidon Ave, Suite 100, Wichita, KS 672032117 | 3166607540 | 3166607588 |
Street Address |
1421 E 2ND ST N |
City | WICHITA |
State | KS |
Zip Code | 67214-4119 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1043723497 | Mental Health Medication Services, P.a. | Psychiatry & Neurology | 1421 E 2nd St N, Wichita, KS 67214-4119 | 2017-11-08 |
1194120634 | Helen Frances Smalley | Counselor | 1421 E 2nd St N, Wichita, KS 67214-4119 | 2014-10-27 |
1245404151 | Family Counseling Center Pa | Social Worker | 1421 E 2nd St N, Wichita, KS 67214-4119 | 2008-04-22 |
1649488529 | Angie Marie Mooneyham | Marriage & Family Therapist | 1421 E 2nd St N, Wichita, KS 67214-4119 | 2007-05-21 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1124591185 | Laquita Patrice Boyede | Durable Medical Equipment & Medical Supplies | 1503 Northeast Parkway, Wichita, KS 67214 | 2019-01-02 |
1891270674 | Kathryn Denise Boomer | Physician Assistant | 929 St. Francis N, Wichita, KS 67214 | 2018-09-27 |
1447756457 | Cardinal Health 132 LLC | Pharmacy | 527 N Grove Street, Suite 100, Wichita, KS 67214 | 2018-03-30 |
1023517174 | Laboratory Corporation of America Holdings | Clinical Medical Laboratory | 3243 E Murdock Street, Level G, Wichita, KS 67214 | 2018-02-05 |
1558887901 | Shonnetta Lachan Gabriel | Counselor | 2707 E. 21st St. N, Wichita, KS 67214 | 2017-08-17 |
1417492174 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 803 N Broadway Ave, Wichita, KS 67214 | 2017-01-04 |
1952850653 | Rachel J Johnson | Counselor | 805 N Volutsia, Wichita, KS 67214 | 2016-09-23 |
1063899813 | Christy Lee Foos | Social Worker | 2707 E. 21st St. North, Healthcore Clinic, Wichita, KS 67214 | 2015-04-30 |
1952708018 | William Schroeder Fargo | Specialist | 701 N. Emporia, Wichita, KS 67214 | 2014-12-04 |
1447692710 | Valeriya V Hunter | Dentist | 527 N Grove, Wichita, KS 67214 | 2013-07-26 |
Find all providers in zip 67214 |
Taxonomy Code | 363LP0808X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Psych/Mental Health |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1023658663 | Boniface Ndungu Gitau | Nurse Practitioner | 6003 E Bayley St, Wichita, KS 67218-3505 | 2020-01-12 |
1083262695 | Andrea Michelle Rogers | Nurse Practitioner | 7829 E Rockhill St Ste 105, Wichita, KS 67206-3919 | 2019-08-27 |
1487132171 | Kristal Lynn Lang | Nurse Practitioner | 7570 W 21st St, Suite 1026d, Wichita, KS 67205-1764 | 2018-08-03 |
1114334067 | Jane Crawford | Nurse Practitioner | 8623 E 32nd St N, Wichita, KS 67226 | 2014-07-11 |
1134375280 | Susan Mileham | Nurse Practitioner | 1660 N Tyler Rd Ste A, Wichita, KS 67212-4918 | 2008-08-08 |
1174657225 | Anderson Family Health, Inc. | Nurse Practitioner | 2808 E Central Ave, Wichita, KS 67214-4707 | 2007-03-14 |
1780765438 | Arian A Riordan | Nurse Practitioner | 8901 E Orme St, Wichita, KS 67207-2473 | 2006-10-18 |
1508962945 | Ana Sarra Ahrens | Nurse Practitioner | 1919 N Amidon Ave Ste 317, Wichita, KS 67203-2120 | 2006-09-15 |
1598760381 | Paula Skinner | Nurse Practitioner | 934 N Water St, Wichita, KS 67203-3838 | 2005-06-17 |
1245234723 | Kathleen A Barrett | Nurse Practitioner | 347 S Laura St, Wichita, KS 67211-1518 | 2005-06-13 |
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.