GRACEMED EVERGREEN FAMILY CLINIC


Address: 2700 N Woodland St, Wichita, KS 67204-5158
Phone: 3168662000

GRACEMED EVERGREEN FAMILY CLINIC (NPI# 1912333774) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1912333774
Entity Type Organization
Organization Name GRACEMED EVERGREEN FAMILY CLINIC
Practice Address 2700 N Woodland St
Wichita
KS 67204-5158
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 2013-09-24
Last Update Date 2013-09-24
Authorized Official Name MR. DAVID C SANFORD (CEO)
Authorized Official Telephone 3168662001
Is Organization Subpart Y
Parent Organization Name GRACEMED HEALTH CLINIC, INC

Taxonomy

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 Provider Identifier

State Issuer Identifier Type Code
KS 100212250A 05

Office Location

Street Address 2700 N WOODLAND ST
City WICHITA
State KS
Zip Code 67204-5158

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1952570657 Wal-mart Store, Inc. Eyewear Supplier (Equipment, not the service) 5475 N. Meridian, Wichita, KS 67204 2008-02-27
1992907141 Diane Jeanette Casey Physical Therapist 2812 W 61 St N, Rehab & Consulting Pa, Wichita, KS 67204 2007-06-01
1477534030 Yvonne Lara Saunders-teigeler Family Medicine 3443 North Amidon Avenue, Wichita, KS 67204 2005-11-10
1487836110 Walmart Inc. Durable Medical Equipment & Medical Supplies 5475 N Meridian Ave, Wichita, KS 67204-1620 2007-12-05
1083152540 Ray Tejeda Pharmacist 5475 N Meridian Ave, Wichita, KS 67204-1620 2017-02-05
1265989305 Sanjiv Patel Pharmacist 5475 N Meridian Ave, Wichita, KS 67204-1620 2016-09-07
1962618041 Laquita Riley Physical Therapist 5701 N Sedgwick St, Wichita, KS 67204-1831 2007-05-15
1417276791 House Call Medical Services Nurse Practitioner 5721 N Athenian Ave, Wichita, KS 67204-1844 2010-05-25
1710008495 Home Care Equipment, Inc. Durable Medical Equipment & Medical Supplies 703 W 53rd St N, Wichita, KS 67204-2237 2007-04-02
1962903906 Nalini Fraser Pharmacist 2806 W Driftwood Cir, Wichita, KS 67204-2340 2018-02-26
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Taxonomy Information

Taxonomy Code 261QF0400X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Federally Qualified Health Center (FQHC)

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

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
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
1861859787 Gracemed Health Clinic, Inc Clinic/Center 1919 N Amidon Ave, Suite 100, Wichita, KS 67203-2117 2016-01-22
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Competitor

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City WICHITA
Zip Code 67204

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Dataset Information

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.

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