KANSAS MEDICAL CENTER, LLC (NPI# 1801007786) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801007786 |
| Entity Type | Organization |
| Organization Name | KANSAS MEDICAL CENTER, LLC |
| Other Organization Name | KMC PHYSICIANS |
| Practice Address |
1124 W. 21st St Andover KS 67002 |
| Mailing Address |
Po Box 268938 Department 96 0511 Oklahoma City OK 73196-0511 |
| Practice Telephone | 3163004000 |
| Practice Fax Number | 3163004040 |
| Mailing Telephone | 3163004021 |
| Mailing Fax Number | 3163004040 |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2016-05-12 |
| Authorized Official Name | MR. DARYL THORNTON (CHIEF OPERATING OFFICER) |
| Authorized Official Telephone | 3163004021 |
| Is Organization Subpart | Y |
| Parent Organization Name | KANSAS MEDICAL CENTER, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | KS | Allopathic & Osteopathic Physicians | |
| Y | 207PE0004X |
Emergency Medicine Specialization: Emergency Medical Services |
KS | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KS | BSBSKS | 111283 | 01 |
| KS | 200408390B | 05 | |
| KS | RR MEDICARE | DN3967 | 01 |
| Other Name | Type Code |
|---|---|
| KMC Physicians | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407304256 | Kansas Medical Center, LLC | General Acute Care Hospital | 1124 W 21st St, Andover, KS 67002-5500 | 2016-09-21 |
| 1407237381 | Kansas Medical Center, LLC | Family Medicine | 1410 N Woodlawn Blvd, Derby, KS 67037-2953 | 2015-06-16 |
| 1952585341 | Kansas Medical Center, LLC | Internal Medicine | 1124 W 21st St, Andover, KS 67002-5500 | 2007-12-21 |
| 1952512832 | Kansas Medical Center, LLC | Anesthesiology | 1124 W. 21st St, Andover, KS 67002 | 2007-05-24 |
| Street Address |
1124 W. 21ST ST |
| City | ANDOVER |
| State | KS |
| Zip Code | 67002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952512832 | Kansas Medical Center, LLC | Anesthesiology | 1124 W. 21st St, Andover, KS 67002 | 2007-05-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386262707 | Rachel Marie Porter | Nurse Practitioner | Andover Family Medicine, 2117 N Keystone Circle, Andover, KS 67002 | 2020-07-13 |
| 1033535695 | Michael L Ray | Chiropractor | 1145 N Andover Rd Ste 109, Andover, KS 67002 | 2014-03-06 |
| 1225372949 | Lisa Hua Lee | Physical Therapy Assistant | 811 N Crescent Lakes Cir, Andover, KS 67002 | 2012-11-19 |
| 1689992752 | Andover Senior Care, LLC | Skilled Nursing Facility | 224 E Central Ave, Andover, KS 67002 | 2010-05-13 |
| 1033303136 | Casey T Hummel | Chiropractor | 550 North Andover Road, Andover, KS 67002 | 2007-08-31 |
| 1205929957 | Sitha Uy Miller | Internal Medicine | 943 N. Andover Road, Andover, KS 67002 | 2006-10-02 |
| 1275644650 | Shala Renee Holman | Physician Assistant | 1124 W. 21st Street, Andover, KS 67002 | 2006-08-31 |
| 1497869168 | Allan Michael Weilert | Chiropractor | 202 E Rhondda St, Ste A, Andover, KS 67002 | 2006-08-18 |
| 1407872708 | Lindsay Marie Landers | Family Medicine | 105 S Andover Rd, Suite D, Andover, KS 67002 | 2006-07-14 |
| 1295770782 | Ashley Ralston | Optometrist | 308 E Central Ave Ste 100, Andover, KS 67002 | 2006-06-18 |
| Find all providers in zip 67002 | ||||
| Taxonomy Code | 207PE0004X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| Specialization | Emergency Medical Services |
| An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306301429 | Rikkie Renee Thouvenell | Emergency Medicine | 906 S Lincoln Ave, Chanute, KS 66720-3041 | 2019-02-02 |
| 1124594957 | Susan B. Allen Memorial Hospital | Emergency Medicine | 700 W Central Ave Ste 103, El Dorado, KS 67042-2187 | 2018-10-19 |
| 1609185958 | Barbara K Lomeli | Emergency Medicine | 14500 S Quivira Rd, Olathe, KS 66062-9479 | 2010-10-05 |
| 1124086384 | Daniel W Doherty | Emergency Medicine | 315 W 15th Street, Liberal, KS 67905-1340 | 2006-05-03 |
| 1104815265 | Phillips County | Emergency Medicine | 409 E St, Box 309, Phillipsburg, KS 67661-1656 | 2005-10-20 |
| 1912530890 | Edward King | Emergency Medicine | 1428 S Main St Ste 4, Ottawa, KS 66067-3547 | 2020-02-19 |
| 1851867709 | Johnny Huy Nguyen | Emergency Medicine | 929 N Saint Francis St, Wichita, KS 67214-3821 | 2018-10-18 |
| 1912362682 | Newman Medical Partners LLC | Emergency Medicine | 2720 W 15th Ave, Emporia, KS 66801 | 2015-12-23 |
| 1730494048 | Kansas Physicians Group, LLC | Emergency Medicine | 2610 N Woodlawn Blvd, Wichita, KS 67220-2729 | 2010-08-11 |
| 1700106168 | Joshua David Korosac | Emergency Medicine | 325 Maine St, Lawrence, KS 66044-1360 | 2010-06-08 |
| Find all providers with the same taxonomy | ||||
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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.