PRAIRIE GYNECOLOGY PA (NPI# 1952670077) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952670077 |
| Entity Type | Organization |
| Organization Name | PRAIRIE GYNECOLOGY PA |
| Practice Address |
12115 E 21st St N Ste 107 Wichita KS 67206-3567 |
| Mailing Address |
13716 E Mainsgate St Wichita KS 67228-8049 |
| Practice Telephone | 3163052093 |
| Mailing Telephone | 3163052093 |
| Enumeration Date | 2011-12-19 |
| Last Update Date | 2011-12-19 |
| Authorized Official Name | DR. AMY C SHORT (CHAIRMAN, BOARD OF DIRECTORS) |
| Authorized Official Telephone | 3163052330 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | 0433994 | KS | Allopathic & Osteopathic Physicians |
| Street Address |
12115 E 21ST ST N STE 107 |
| City | WICHITA |
| State | KS |
| Zip Code | 67206-3567 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285675413 | Jeff P Davis | Family Medicine | 12115 E 21st St N, Suite 107, Wichita, KS 67206-3567 | 2006-06-09 |
| 1427583061 | Julie Davis | Occupational Therapist | 12115 E 21st St N, Suite 107, Wichita, KS 67206-3567 | 2017-04-20 |
| 1649625070 | Kristen Marvin | Naturopath | 12115 E 21st St N, Suite 107, Wichita, KS 67206-3567 | 2016-05-04 |
| 1477926301 | Prairie Health and Wellness | Naturopath | 12115 E 21st St N, Suite 107, Wichita, KS 67206-3567 | 2015-10-30 |
| 1699189043 | Prairie Endoscopy LLC | Family Medicine | 12115 E 21st St N, Suite 107, Wichita, KS 67206-3567 | 2014-06-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760020846 | Founders Surgery Center, LLC | Clinic/Center | 1961 N Founders Circle, Wichita, KS 67206 | 2019-12-19 |
| 1174006613 | Courtney Dawn Simon | Physical Therapist | 9360 E Central Ave Ste 100, Wichita, KS 67206 | 2018-09-11 |
| 1902308919 | Center At Waterfront LLC | Skilled Nursing Facility | 1541 North Lindberg Circle, Wichita, KS 67206 | 2018-03-06 |
| 1750804597 | Katelyn Aguiar | Psychologist | 250 N Rock Rd Ste 210, Wichita, KS 67206 | 2017-07-24 |
| 1457888778 | Mona Kay Cherryholmes | Social Worker | 1223 N. Rock Rd, Bldg A. Suite 100, Wichita, KS 67206 | 2017-05-17 |
| 1164899415 | Elizabeth Herl | Marriage & Family Therapist | 250 N Rock Rd Ste 150, Wichita, KS 67206 | 2015-08-21 |
| 1851715510 | Ndjj Corp | Custodial Care Facility | 6403 E Marjore, Wichita, KS 67206 | 2014-02-14 |
| 1801238217 | Courtney Ann Lang | Physical Therapist | 1603 North Chapel Hill Street, Suite 400, Wichita, KS 67206 | 2013-07-26 |
| 1194063032 | Peak Performance Health Pa | Chiropractor | 10111 E 21st St, #106, Wichita, KS 67206 | 2013-01-28 |
| 1750629002 | Rachel Marie Conrad | Speech-Language Pathologist | 1861 N. Rock Rd, Ste 101, Wichita, KS 67206 | 2013-01-22 |
| Find all providers in zip 67206 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023308939 | Damen Wayne Hershberger | Obstetrics & Gynecology | 9300 E 29th St N Ste 320, Wichita, KS 67226-2184 | 2011-04-12 |
| 1053639807 | Preferred Medical Associates | Obstetrics & Gynecology | 14700 W. St. Teresa, Ste. 370, Wichita, KS 67235-9600 | 2010-05-04 |
| 1659547479 | Lueke B Lueken | Obstetrics & Gynecology | 2760 S Roosevelt St, Wichita, KS 67210-1304 | 2008-05-01 |
| 1073783437 | Veerayyagari Annapurna | Obstetrics & Gynecology | 9300 E 29th St N Ste 201, Wichita, KS 67226-2183 | 2008-03-01 |
| 1417068727 | Victoria W Kindel | Obstetrics & Gynecology | 3232 E Murdock, Wichita, KS 67208-3003 | 2006-08-31 |
| 1821008285 | Michael D Wolfe | Obstetrics & Gynecology | 1515 S Clifton Ave Ste 400, Wichita, KS 67218-2961 | 2006-08-09 |
| 1801814934 | Steven L Zielke | Obstetrics & Gynecology | 5109 W Wavecrest Cir, Wichita, KS 67205-1322 | 2006-07-17 |
| 1699709923 | Women's Medcenter, Pa | Obstetrics & Gynecology | 223 S Hillside St, Wichita, KS 67211-2128 | 2006-07-11 |
| 1700840550 | Valerie Elizabeth Drake-albert | Obstetrics & Gynecology | 1855 N Webb Rd, Wichita, KS 67206-3413 | 2006-04-17 |
| 1992700710 | Michael D Bates | Obstetrics & Gynecology | 9300 E 29th St N, Ste 201, Wichita, KS 67226-2183 | 2005-06-17 |
| 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.