PRAIRIE ENDOSCOPY LLC (NPI# 1699189043) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699189043 |
| Entity Type | Organization |
| Organization Name | PRAIRIE ENDOSCOPY LLC |
| Practice Address |
12115 E 21st St N Suite 107 Wichita KS 67206-3567 |
| Practice Telephone | 3164407000 |
| Practice Fax Number | 3164407006 |
| Mailing Telephone | 3164407000 |
| Mailing Fax Number | 3164407006 |
| Enumeration Date | 2014-06-13 |
| Last Update Date | 2014-06-25 |
| Authorized Official Name | JEFFREY P DAVIS (SOLE OWNER) |
| Authorized Official Telephone | 3164407000 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | 04-30240 | KS | Allopathic & Osteopathic Physicians |
| Y | 261QE0800X |
Clinic/Center Specialization: Endoscopy |
04-30240 | KS | Ambulatory Health Care Facilities |
| Street Address |
12115 E 21ST ST N SUITE 107 |
| City | WICHITA |
| State | KS |
| Zip Code | 67206-3567 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285675413 | Jeff P Davis | Family Medicine | 12115 E 21st St N, Suite 107, Wichita, KS 67206-3567 | 2006-06-09 |
| 1427583061 | Julie Davis | Occupational Therapist | 12115 E 21st St N, Suite 107, Wichita, KS 67206-3567 | 2017-04-20 |
| 1649625070 | Kristen Marvin | Naturopath | 12115 E 21st St N, Suite 107, Wichita, KS 67206-3567 | 2016-05-04 |
| 1477926301 | Prairie Health and Wellness | Naturopath | 12115 E 21st St N, Suite 107, Wichita, KS 67206-3567 | 2015-10-30 |
| 1952670077 | Prairie Gynecology Pa | Obstetrics & Gynecology | 12115 E 21st St N, Ste 107, Wichita, KS 67206-3567 | 2011-12-19 |
| 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 | 261QE0800X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Endoscopy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316043631 | Via Christi Clinic, Pa | Clinic/Center | 3311 E Murdock St, Wichita, KS 67208-3054 | 2006-09-15 |
Please comment or provide details below to improve the information on PRAIRIE ENDOSCOPY LLC.
| 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.