WICHITA NEPHROLOGY GROUP, PA (NPI# 1396238010) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396238010 |
| Entity Type | Organization |
| Organization Name | WICHITA NEPHROLOGY GROUP, PA |
| Other Organization Name | REVASK SURGERY CENTER LLC |
| Practice Address |
2122 N Garnett St Wichita KS 67206-3023 |
| Mailing Address |
818 N Emporia St Ste 310 Wichita KS 67214-3727 |
| Practice Telephone | 3166361234 |
| Practice Fax Number | 3166362630 |
| Mailing Telephone | 3162635891 |
| Mailing Fax Number | 3162633083 |
| Enumeration Date | 2018-06-07 |
| Last Update Date | 2018-10-16 |
| Authorized Official Name | WISSAM SALIBA (DIRECTOR) |
| Authorized Official Telephone | 3162635891 |
| Authorized Official Credential | MD |
| Is Organization Subpart | Y |
| Parent Organization Name | WICHITA NEPHROLOGY GROUP, PA |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
04-35548 | KS | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Renal Vascular Access & Surgicenter of Kansas | Doing Business As Name - Organization |
| ReVask Surgery Center LLC | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104877810 | Wichita Nephrology Group, Pa | Internal Medicine | 818 N Emporia St, Suite 310, Wichita, KS 67214 | 2006-05-15 |
| Street Address |
2122 N GARNETT ST |
| City | WICHITA |
| State | KS |
| Zip Code | 67206-3023 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760020846 | Founders Surgery Center, LLC | Clinic/Center | 1961 N Founders Circle, Wichita, KS 67206 | 2019-12-19 |
| 1174006613 | Courtney Dawn Simon | Physical Therapist | 9360 E Central Ave Ste 100, Wichita, KS 67206 | 2018-09-11 |
| 1902308919 | Center At Waterfront LLC | Skilled Nursing Facility | 1541 North Lindberg Circle, Wichita, KS 67206 | 2018-03-06 |
| 1750804597 | Katelyn Aguiar | Psychologist | 250 N Rock Rd Ste 210, Wichita, KS 67206 | 2017-07-24 |
| 1457888778 | Mona Kay Cherryholmes | Social Worker | 1223 N. Rock Rd, Bldg A. Suite 100, Wichita, KS 67206 | 2017-05-17 |
| 1164899415 | Elizabeth Herl | Marriage & Family Therapist | 250 N Rock Rd Ste 150, Wichita, KS 67206 | 2015-08-21 |
| 1851715510 | Ndjj Corp | Custodial Care Facility | 6403 E Marjore, Wichita, KS 67206 | 2014-02-14 |
| 1801238217 | Courtney Ann Lang | Physical Therapist | 1603 North Chapel Hill Street, Suite 400, Wichita, KS 67206 | 2013-07-26 |
| 1194063032 | Peak Performance Health Pa | Chiropractor | 10111 E 21st St, #106, Wichita, KS 67206 | 2013-01-28 |
| 1750629002 | Rachel Marie Conrad | Speech-Language Pathologist | 1861 N. Rock Rd, Ste 101, Wichita, KS 67206 | 2013-01-22 |
| Find all providers in zip 67206 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760020846 | Founders Surgery Center, LLC | Clinic/Center | 1961 N Founders Circle, Wichita, KS 67206 | 2019-12-19 |
| 1457757346 | South Wind Women's Centter, LLC | Clinic/Center | 5701 E Kellogg Drive, Wichita, KS 67218 | 2014-11-05 |
| 1811262363 | Precision Surgery Center, LLC | Clinic/Center | 1857 N. Webb Road, Wichita, KS 67206 | 2012-03-16 |
| 1356488837 | Ridgewood Surgery and Endoscopy Center LLC | Clinic/Center | 4013 North Ridge Road, Wichita, KS 67205-8822 | 2007-01-31 |
| 1205862984 | Endoscopic Services, P.a. | Clinic/Center | 1431 Bluffview St Ste 215, Wichita, KS 67218-3039 | 2006-06-24 |
| 1659327245 | Cosmetic & Reconstructive Surgery Center, Pa | Clinic/Center | 1700 N Waterfront Pkwy, Building 200, Wichita, KS 67206-6614 | 2006-05-25 |
| 1073581880 | Ambulatory Surgery Center Lp | Clinic/Center | 818 N Emporia, Ste 108, Wichita, KS 67214 | 2006-03-08 |
| 1295119584 | Wichita Asc Lp | Clinic/Center | 3555 North Webb Rd., Suite B, Wichita, KS 67226 | 2015-07-16 |
| 1336547421 | Associated Eye Surgical Center LLC | Clinic/Center | 1100 N Topeka St, Wichita, KS 67214-2810 | 2014-12-05 |
| 1164742565 | Kansas Joint & Spine Institute | Clinic/Center | 10100 Shannon Woods St, Wichita, KS 67226-4103 | 2010-06-08 |
| 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.