PEDIATRIX MEDICAL GROUP OF KANSAS PA (NPI# 1346347051) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346347051 |
| Entity Type | Organization |
| Organization Name | PEDIATRIX MEDICAL GROUP OF KANSAS PA |
| Practice Address |
550 N Hillside Ave Wichita KS 67214-4910 |
| Mailing Address |
1301 Concord Ter Sunrise FL 33323-2843 |
| Practice Telephone | 3169628550 |
| Practice Fax Number | 3169628581 |
| Mailing Telephone | 9543840175 |
| Mailing Fax Number | 9548511948 |
| Enumeration Date | 2006-09-17 |
| Last Update Date | 2011-01-12 |
| Authorized Official Name | BARRY T BLOOM (PRESIDENT) |
| Authorized Official Telephone | 9543840175 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080N0001X |
Pediatrics Specialization: Neonatal-Perinatal Medicine |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 149977992 | 05 | |
| KS | 100216930E | 05 | |
| KS | 100216930A | 05 | |
| KS | 100216930B | 05 | |
| KS | 100216930C | 05 | |
| KS | 100216930D | 05 | |
| KS | 100216930F | 05 |
| Street Address |
550 N HILLSIDE AVE |
| City | WICHITA |
| State | KS |
| Zip Code | 67214-4910 |
| 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 | 2080N0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Neonatal-Perinatal Medicine |
| A pediatrician who is the principal care provider for sick newborn infants. Clinical expertise is used for direct patient care and for consulting with obstetrical colleagues to plan for the care of mothers who have high-risk pregnancies. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629073812 | Philippe Samson | Pediatrics | 3600 E Harry St, Wichita, KS 67218-3713 | 2005-06-15 |
| 1629610076 | Meghan Elizabeth Jorgensen | Pediatrics | 550 N Hillside St, Wichita, KS 67214-4910 | 2019-10-16 |
| 1144644303 | Shubika D'souza | Pediatrics | 550 N Hillside St, Wichita, KS 67214-4910 | 2014-02-08 |
| 1588868145 | Cynthia Elizabeth Strand-smart | Pediatrics | 3600 E Harry St, Wichita, KS 67218-3713 | 2007-06-14 |
| 1912059205 | William Randall Reed | Pediatrics | 550 N Hillside St, Wichita, KS 67214-4910 | 2007-01-17 |
| 1174562920 | Carolyn K Johnson | Pediatrics | 550 N Hillside St, Wichita, KS 67214-4910 | 2006-06-06 |
| 1992758601 | Robert Hsiao | Pediatrics | 550 N Hillside St, Wichita, KS 67214-4910 | 2006-05-17 |
| 1750349734 | Taysir Shash | Pediatrics | 3600 E Harry St, Wichita, KS 67218-3713 | 2006-05-01 |
| 1043274566 | Barry Theil Bloom | Pediatrics | 550 N Hillside St, Wesley Department of Neonatology, Wichita, KS 67214-4910 | 2006-04-13 |
| 1336102821 | Curtis Caylor Dorn | Pediatrics | 550 N Hillside St, Department of Neonatology, Wichita, KS 67214-4910 | 2006-04-07 |
| 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.