LARRY E CHUPP (NPI# 1750371456) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750371456 |
| Entity Type | Individual |
| Full Name | LARRY E CHUPP |
| Credential | PA-C, MPAS |
| Practice Address |
22 Mdg 57950 Leavenworth St Mcconnell Afb KS 67221-3506 |
| Mailing Address |
1109 S Breckenridge Ct Wichita KS 67207-3632 |
| Practice Telephone | 3167591970 |
| Mailing Telephone | 3163471882 |
| Enumeration Date | 2005-10-24 |
| Last Update Date | 2016-09-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
22 MDG 57950 LEAVENWORTH ST |
| City | MCCONNELL AFB |
| State | KS |
| Zip Code | 67221-3506 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760616015 | John La Cruz | Military Health Care Provider | 22 Mdg, Mcconnell Afb, KS 67221-3712 | 2009-05-14 |
| 1922232271 | Richard Jimenez Rubi | Military Health Care Provider | 22 Mdg, Mcconnell Afb, KS 67221 | 2009-05-14 |
| 1023071107 | Daniel Robert Lamothe | General Practice | 22 Mdg, 57950 Leavenworth St, Mcconnell Afb, KS 67221-3506 | 2006-04-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922528421 | Rose Lee Samples | Nurse Practitioner | 51950 Leavenworth St., Family Health Clinic 22 Mdg, Mcconnell Afb, KS 67221 | 2017-06-26 |
| 1114247913 | Dawn Marie Clifton | Nurse Practitioner | 57950 Leavenworth Ave Bldg 250, 22d Medical Group, Mcconnell Afb, KS 67221 | 2010-06-03 |
| 1467514489 | 22nd Medical Group | Pharmacy | 57590 Leavenworth Bldg 250, Mcconnell Afb, KS 67221 | 2006-12-15 |
| 1336182153 | National Vision, Inc. | Eyewear Supplier (Equipment, not the service) | Derby Street, Building 352, Mcconnell Afb, KS 67221 | 2006-06-13 |
| 1578919049 | Kathryn Rachel Kocher | Pediatrics | 57950 Leavenworth St, Mcconnell Afb, KS 67221 | 2016-05-13 |
| 1962707067 | Melissa M Wendt | Physician Assistant | 57950 Leavenworth St Ste 4e1, Mcconnell Afb, KS 67221 | 2011-01-20 |
| 1871581306 | Joshua A Hartman | Emergency Medicine | 57950 Leavenworth St Bldg 248, Mcconnell Afb, KS 67221-3505 | 2005-10-10 |
| 1184242604 | Lindsey Allison Cunningham | Dentist | 57950 Leavenworth St, Wichita, KS 67221-3505 | 2020-07-10 |
| 1164052700 | Taylor Holloway | Family Medicine | 57950 Leavenworth St Bldg 250, Mcconnell Afb, KS 67221-3505 | 2020-01-23 |
| 1407296940 | Daniel Richard Galle | Optometrist | 57950 Leavenworth St Ste 4e1, Mcconnell Afb, KS 67221-3505 | 2013-06-28 |
| Find all providers in zip 67221 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487277703 | Riann Paige Tyree | Physician Assistant | 724 W Lincoln Ave, Greensburg, KS 67054-2522 | 2020-05-20 |
| 1891270674 | Kathryn Denise Boomer | Physician Assistant | 929 St. Francis N, Wichita, KS 67214 | 2018-09-27 |
| 1912408717 | Alyssa Ann Farrell | Physician Assistant | 235 W Vine St., Dighton, KS 67839 | 2018-02-27 |
| 1740790500 | Tory Christopher Fisher | Physician Assistant | 22450 S Harrison St Ste 100, Spring Hill, KS 66083-8882 | 2017-10-06 |
| 1619407871 | Lisa Raylene Steers | Physician Assistant | Po Box 10, Hugoton, KS 67951-0010 | 2017-06-19 |
| 1922547371 | Anna Ruelberg | Physician Assistant | 4921 W 18th Street, Lawrence, KS 66047-2090 | 2017-02-17 |
| 1255888319 | Morgan J Martin | Physician Assistant | 2610 N Woodlawn, Wichita, KS 67220 | 2016-09-07 |
| 1598135808 | Tracy Hoelting | Physician Assistant | 1150 N 75th Pl Ste 200, Kansas City, KS 66112-2466 | 2015-09-29 |
| 1437409901 | Crystal A Nelson | Physician Assistant | 9350 E 35th St N, Ste 101, Wichita, KS 67226 | 2012-09-12 |
| 1306195193 | Jessica M Hughbanks | Physician Assistant | 101 Industrial Rd, Hillsboro, KS 67063-9602 | 2012-09-07 |
| Find all providers with the same taxonomy | ||||
| City | MCCONNELL AFB |
| Zip Code | 67221 |
Please comment or provide details below to improve the information on LARRY E CHUPP.
| 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.