GRACEMED HEALTH CLINIC, INC (NPI# 1730575069) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730575069 |
| Entity Type | Organization |
| Organization Name | GRACEMED HEALTH CLINIC, INC |
| Other Organization Name | GRACEMED JARDINE FAMILY CLINIC |
| Practice Address |
3610 E Ross Pkwy Wichita KS 67210-1311 |
| Mailing Address |
1122 N Topeka St Wichita KS 67214-2810 |
| Practice Telephone | 3168662000 |
| Practice Fax Number | 3168662084 |
| Mailing Telephone | 3168662000 |
| Mailing Fax Number | 3168662084 |
| Enumeration Date | 2015-04-14 |
| Last Update Date | 2015-04-14 |
| Authorized Official Name | MR. DAVID C SANFORD (CEO) |
| Authorized Official Telephone | 3168662001 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| GraceMed Jardine Family Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932579513 | Gracemed Health Clinic, Inc | Clinic/Center | 755 W. Lincoln St, Wichita, KS 67213 | 2015-09-25 |
| 1992113898 | Gracemed Health Clinic, Inc | Clinic/Center | 5000 S Clifton Ave Ste 200, Wichita, KS 67216-3408 | 2014-07-24 |
| 1952651713 | Gracemed Health Clinic, Inc | Clinic/Center | 4910 W 1st St N, Wichita, KS 67212-2341 | 2012-09-19 |
| 1568947737 | Gracemed Health Clinic, Inc | Clinic/Center | 101 E Ross St, Clearwater, KS 67026-7824 | 2018-10-03 |
| 1437697174 | Gracemed Health Clinic, Inc | Pharmacy | 1122 N Topeka St, Wichita, KS 67214-2810 | 2017-02-02 |
| 1871035709 | Gracemed Health Clinic, Inc | Clinic/Center | 322 N Main St, Suite 100, Mcpherson, KS 67460-4308 | 2016-11-09 |
| 1285083469 | Gracemed Health Clinic, Inc | Clinic/Center | 2025 Se California Ave, Topeka, KS 66607-1443 | 2016-06-08 |
| 1194174482 | Gracemed Health Clinic, Inc | Clinic/Center | 1615 Sw 8th Ave, Topeka, KS 66606-1633 | 2016-06-07 |
| 1053770818 | Gracemed Health Clinic, Inc | Clinic/Center | 3417 S Meridian Ave, Wichita, KS 67217-2151 | 2016-02-22 |
| 1861859787 | Gracemed Health Clinic, Inc | Clinic/Center | 1919 N Amidon Ave, Suite 100, Wichita, KS 67203-2117 | 2016-01-22 |
| Street Address |
3610 E ROSS PKWY |
| City | WICHITA |
| State | KS |
| Zip Code | 67210-1311 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912999020 | Cynthia Marie Pinkerton | Nurse Practitioner | 3610 E Ross Pkwy, Wichita, KS 67210-1311 | 2005-08-16 |
| 1871888248 | Delane Vaughn | Family Medicine | 3610 E Ross Pkwy, Wichita, KS 67210-1311 | 2011-06-14 |
| 1427253921 | Devin Wesley Penny | Family Medicine | 3610 E Ross Pkwy, Wichita, KS 67210-1311 | 2007-06-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043503642 | Allegiance Home Care Services, Inc | In Home Supportive Care | 8527 E Creed St, Wichita, KS 67210 | 2011-05-16 |
| 1780892604 | Carrie Dawn Couture | Social Worker | 4505 E 47th St. South, Wichita, KS 67210 | 2007-05-21 |
| 1174003412 | Susan Sun | Acupuncturist | 2415 S Glendale St, Wichita, KS 67210-1202 | 2018-08-16 |
| 1659547479 | Lueke B Lueken | Obstetrics & Gynecology | 2760 S Roosevelt St, Wichita, KS 67210-1304 | 2008-05-01 |
| 1730288861 | Kathryn S. Wolfe-wappelhorst | Physician Assistant | 2750 S Roosevelt St, Hunter Health Brookside Clinic, Wichita, KS 67210-1304 | 2006-09-22 |
| 1053487579 | Hunter Health Clinic, Inc | Clinic/Center | 2750 S Roosevelt St, Wichita, KS 67210-1304 | 2006-11-27 |
| 1528024742 | Healthy Options for Planeview | Dentist | 3620 E Sunnybrook Ln, Suite C, Wichita, KS 67210-1464 | 2006-04-25 |
| 1518287465 | Nancy Lynn Ross | Social Worker | 3620 E Sunnybrook Ln, Suite C, Wichita, KS 67210-1464 | 2010-06-02 |
| 1346576899 | Healthy Options for Kansas Communities (hop), Inc. | Clinic/Center | 3620 E Sunnybrook Ln, Wichita, KS 67210-1464 | 2009-10-19 |
| 1013173624 | Shirley Rae Parish | Nurse Practitioner | 3620 E Sunnybrook Ln, Suite C, Wichita, KS 67210-1464 | 2008-08-03 |
| Find all providers in zip 67210 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932579513 | Gracemed Health Clinic, Inc | Clinic/Center | 755 W. Lincoln St, Wichita, KS 67213 | 2015-09-25 |
| 1992113898 | Gracemed Health Clinic, Inc | Clinic/Center | 5000 S Clifton Ave Ste 200, Wichita, KS 67216-3408 | 2014-07-24 |
| 1043646870 | Gracemed Downing Children Clinic | Clinic/Center | 2201 E 25th St N, Building 200, Wichita, KS 67219-4714 | 2013-09-25 |
| 1356777114 | Gracemed Healthy Family Clinic | Clinic/Center | 1905 S Laura St, Wichita, KS 67211-4422 | 2013-09-24 |
| 1912333774 | Gracemed Evergreen Family Clinic | Clinic/Center | 2700 N Woodland St, Wichita, KS 67204-5158 | 2013-09-24 |
| 1952651713 | Gracemed Health Clinic, Inc | Clinic/Center | 4910 W 1st St N, Wichita, KS 67212-2341 | 2012-09-19 |
| 1174690796 | Hunter Health Clinic, Inc | Clinic/Center | 935 N Market St, Wichita, KS 67214-3521 | 2006-11-29 |
| 1265508337 | Hunter Health Clinic, Inc | Clinic/Center | 238 N Waco St, Wichita, KS 67202-1108 | 2006-11-28 |
| 1841759453 | Hunter Health Clinic, Inc | Clinic/Center | 402 E 2nd St N, Wichita, KS 67202-2504 | 2019-03-14 |
| 1053770818 | Gracemed Health Clinic, Inc | Clinic/Center | 3417 S Meridian Ave, Wichita, KS 67217-2151 | 2016-02-22 |
| 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.