WESLEY MEDICAL CENTER LLC (NPI# 1912052630) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912052630 |
| Entity Type | Organization |
| Organization Name | WESLEY MEDICAL CENTER LLC |
| Other Organization Name | WESLEY PEDIATRIC CRITICAL CARE SERVICES |
| Practice Address |
550 N Hillside St Bldg 1 5th Floor Wichita KS 67214-4910 |
| Mailing Address |
Po Box 47490 Wichita KS 67201-7490 |
| Practice Telephone | 3169627190 |
| Practice Fax Number | 3169622152 |
| Mailing Telephone | 3169623150 |
| Mailing Fax Number | 3169627334 |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2020-09-22 |
| Authorized Official Name | CHERYL A BOLTON (PATIENT ACCOUNTS MANAGER) |
| Authorized Official Telephone | 3169623205 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0203X |
Pediatrics Specialization: Pediatric Critical Care Medicine |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Wesley Pediatric Critical Care Services | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679541627 | Wesley Medical Center LLC | Family Medicine | 850 N Hillside St, Wichita, KS 67214-4914 | 2006-03-08 |
| 1215364161 | Wesley Medical Center LLC | Pharmacy | 2828 N Governeour St, Suite 120, Wichita, KS 67226-1700 | 2013-10-08 |
| 1417235912 | Wesley Medical Center LLC | Clinic/Center | 11120 E 26th St N, Suite 1400, Wichita, KS 67226-4548 | 2011-08-01 |
| 1295833275 | Wesley Medical Center LLC | Internal Medicine | 550 N Hillside, Wichita, KS 67214 | 2006-09-21 |
| 1871691311 | Wesley Medical Center LLC | Clinical Medical Laboratory | 550 N Hillside St, Wichita, KS 67214-4910 | 2006-09-20 |
| 1447299649 | Wesley Medical Center LLC | General Acute Care Hospital | 550 N Hillside St, Wichita, KS 67214-4910 | 2006-06-05 |
| 1467409185 | Wesley Medical Center LLC | Obstetrics & Gynecology | 620 N Carriage Pkwy, Wichita, KS 67208-4501 | 2006-05-28 |
| 1588632145 | Wesley Medical Center LLC | Pediatrics | 550 N Hillside St, Wichita, KS 67214-4910 | 2006-03-09 |
| Street Address |
550 N HILLSIDE ST BLDG 1 5TH FLOOR |
| City | WICHITA |
| State | KS |
| Zip Code | 67214-4910 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770586570 | Debra D Hermes | Physician Assistant | 550 N Hillside St, Wichita, KS 67214-4910 | 2005-05-24 |
| 1255939161 | Sarah Elizabeth Hosp | Nurse Anesthetist, Certified Registered | 550 N Hillside St, Wichita, KS 67214-4910 | 2020-10-13 |
| 1962000273 | Forward Pathology Solutions Wichita, LLC | Pathology | 550 N Hillside St, Wichita, KS 67214-4910 | 2020-10-09 |
| 1073110326 | Amanda Marie Schraeger | Nurse Practitioner | 550 N Hillside St, Wichita, KS 67214-4910 | 2020-10-08 |
| 1942822655 | Katelynn Marie Doran | Pharmacist | 550 N Hillside St, Wichita, KS 67214-4976 | 2020-05-15 |
| 1316569072 | Christina Marie Brummett | Pharmacist | 550 N Hillside St, Wichita, KS 67214-4976 | 2020-05-15 |
| 1629610076 | Meghan Elizabeth Jorgensen | Pediatrics | 550 N Hillside St, Wichita, KS 67214-4910 | 2019-10-16 |
| 1215579883 | Taci Jo Wendler | Registered Nurse | 550 N Hillside St, Wichita, KS 67214-4910 | 2019-10-15 |
| 1023659190 | Julie Lu | Physician Assistant | 550 N Hillside St, Wichita, KS 67214-4910 | 2019-09-30 |
| 1669023131 | Brittany Elizabeth Roberts | Nurse Practitioner | 550 N Hillside St, Wichita, KS 67214-4910 | 2019-09-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124591185 | Laquita Patrice Boyede | Durable Medical Equipment & Medical Supplies | 1503 Northeast Parkway, Wichita, KS 67214 | 2019-01-02 |
| 1891270674 | Kathryn Denise Boomer | Physician Assistant | 929 St. Francis N, Wichita, KS 67214 | 2018-09-27 |
| 1447756457 | Cardinal Health 132 LLC | Pharmacy | 527 N Grove Street, Suite 100, Wichita, KS 67214 | 2018-03-30 |
| 1023517174 | Laboratory Corporation of America Holdings | Clinical Medical Laboratory | 3243 E Murdock Street, Level G, Wichita, KS 67214 | 2018-02-05 |
| 1558887901 | Shonnetta Lachan Gabriel | Counselor | 2707 E. 21st St. N, Wichita, KS 67214 | 2017-08-17 |
| 1417492174 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 803 N Broadway Ave, Wichita, KS 67214 | 2017-01-04 |
| 1952850653 | Rachel J Johnson | Counselor | 805 N Volutsia, Wichita, KS 67214 | 2016-09-23 |
| 1063899813 | Christy Lee Foos | Social Worker | 2707 E. 21st St. North, Healthcore Clinic, Wichita, KS 67214 | 2015-04-30 |
| 1952708018 | William Schroeder Fargo | Specialist | 701 N. Emporia, Wichita, KS 67214 | 2014-12-04 |
| 1447692710 | Valeriya V Hunter | Dentist | 527 N Grove, Wichita, KS 67214 | 2013-07-26 |
| Find all providers in zip 67214 | ||||
| Taxonomy Code | 2080P0203X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Critical Care Medicine |
| A pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source added] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. ACGME Accredited Residency Program Requirements: 2 years of training with 3 years Pediatrics plus 1 year Pediatric Critical Care for certification for a total of 6 years. ABMS Approved Subspecialty Certificate (Pediatrics) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588070130 | Nisha Agasthya | Pediatrics | 550 N Hillside, Wesley Medical Center/picu, Wichita, KS 67214 | 2014-07-03 |
| 1114260676 | Monica Quinn | Pediatrics | 550 N Hillside St, Wichita, KS 67214-4910 | 2013-04-03 |
| 1104112143 | Poornima Pandiyan | Pediatrics | 550 N Hillside St, Wichita, KS 67214-4910 | 2011-06-28 |
| 1215162326 | Priyank Jayeshkumar Yagnik | Pediatrics | 550 N Hillside St, Wichita, KS 67214-4910 | 2009-05-19 |
| 1790712107 | Lindall E Smith | Pediatrics | 550 N Hillside St, Wichita, KS 67214-4910 | 2006-06-28 |
| 1104861590 | Mercedes V Judkins | Pediatrics | 929 N Saint Francis St, Wichita, KS 67214-3821 | 2006-06-18 |
| 1386634673 | Praveen Kumar Khilnani | Pediatrics | 929 N Saint Francis St, Wichita, KS 67214-3821 | 2005-10-27 |
| 1972508042 | Dimitrious E Stephanopoulos | Pediatrics | 929 N Saint Francis St, Wichita, KS 67214-3821 | 2005-06-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588632681 | Sergey Shushunov | Pediatrics | Division of Pediatric Critical Care, 3901 Rainbow Blvd, Kansas City, KS 66160-0001 | 2006-03-14 |
| 1255631867 | Hammad Ashraf Ganatra | Pediatrics | 3901 Rainbow Blvd, Miller 2023, Kansas City, KS 66160 | 2010-10-29 |
| 1144438250 | Francesca Perez Marques | Pediatrics | 3901 Rainbow Blvd, M 2023, Kansas City, KS 66160-8500 | 2007-05-21 |
| 1396778973 | Muthukumar Vellaichamy | Pediatrics | 1500 Sw 10th Ave, Topeka, KS 66604-1301 | 2006-07-08 |
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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.