FREESTATE HEALTH PLLC (NPI# 1013441930) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013441930 |
| Entity Type | Organization |
| Organization Name | FREESTATE HEALTH PLLC |
| Other Organization Name | FREESTATE |
| Practice Address |
4723 E Douglas Ave Wichita KS 67218-1012 |
| Practice Telephone | 8885051776 |
| Practice Fax Number | 8885051776 |
| Mailing Telephone | 8885051776 |
| Mailing Fax Number | 8885051776 |
| Enumeration Date | 2017-04-18 |
| Last Update Date | 2017-04-18 |
| Authorized Official Name | ELISHA YAGHMAI (PRESIDENT) |
| Authorized Official Telephone | 8885051776 |
| Authorized Official Credential | MD, MPH&TM |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 04-33447 | KS | Allopathic & Osteopathic Physicians |
| N | 208000000X | Pediatrics | 04-33447 | KS | Allopathic & Osteopathic Physicians |
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
04-33447 | KS | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| FreeState | Doing Business As Name - Organization |
| Street Address |
4723 E DOUGLAS AVE |
| City | WICHITA |
| State | KS |
| Zip Code | 67218-1012 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871715086 | Rhanda Marie M Eboh | Psychiatry & Neurology | 4723 E Douglas Ave, Wichita, KS 67218-1012 | 2007-05-03 |
| 1568087153 | Luisa M Taylor | Nurse Practitioner | 4723 E Douglas Ave, Wichita, KS 67218-1012 | 2020-06-10 |
| 1528602414 | Valentina Hain | Nurse Practitioner | 4723 E Douglas Ave, Wichita, KS 67218-1012 | 2019-11-04 |
| 1649738451 | Wichita Allergy & Asthma Specialists, LLC | Allergy & Immunology | 4723 E Douglas Ave, Wichita, KS 67218-1012 | 2019-03-11 |
| 1659822864 | Libertas Corp. | Emergency Medicine | 4723 E Douglas Ave, Wichita, KS 67218-1012 | 2016-10-24 |
| 1912344094 | Hannah Bingham | Internal Medicine | 4723 E Douglas Ave, Wichita, KS 67218-1012 | 2013-05-29 |
| 1760631089 | Buckle My Shoe, LLC | Non-Pharmacy Dispensing Site | 4723 E Douglas Ave, Wichita, KS 67218-1012 | 2008-09-10 |
| 1063618544 | Elisha Navid Yaghmai | Family Medicine | 4723 E Douglas Ave, Wichita, KS 67218-1012 | 2007-06-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114544392 | Diana Ho | Optometrist | 980 Oliver Street, Wichita, KS 67218 | 2020-07-03 |
| 1134773690 | Lily Lopez | Nurse's Aide | 5107 E Kellogg Drive, Wichita, KS 67218 | 2019-08-01 |
| 1750862512 | Kelsi Wenger | Student in an Organized Health Care Education/Training Program | 5500 E Kellog Dr, Wichita, KS 67218 | 2018-08-28 |
| 1770038937 | Hair Replacement Clinic | Specialist | 1815 S Windsor, Wichita, KS 67218 | 2016-08-17 |
| 1457757346 | South Wind Women's Centter, LLC | Clinic/Center | 5701 E Kellogg Drive, Wichita, KS 67218 | 2014-11-05 |
| 1124460787 | Teri Kitchen | Social Worker | 3414 Kinkaid, Wichita, KS 67218 | 2013-07-24 |
| 1053660142 | Glenda Rodgers-lawless, Ph.d., Lcpc, Pa | Community/Behavioral Health | 4601 E Douglas, Wichita, KS 67218 | 2012-09-05 |
| 1649541848 | Stephen Rhinehart | Registered Nurse | 5500 E Kellogg Dr., Wichita, KS 67218 | 2012-01-19 |
| 1457666927 | Recovery Services Council Inc. | Point of Service | 1611 South Rutan, Wichita, KS 67218 | 2010-08-09 |
| 1043535867 | Melissa A Weinley | Respiratory Therapist, Registered | 5500 East Kellog Dr, Wichita, KS 67218 | 2010-04-05 |
| Find all providers in zip 67218 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
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| 1114434420 | Ibis Solutions, LLC | Clinic/Center | 2201 E 13th St N Ste E, Wichita, KS 67214-1903 | 2018-01-08 |
| 1104361963 | Mother's Touch Mobile Physicians, Inc. | Clinic/Center | 319 N Dowell St, Wichita, KS 67206-2789 | 2017-01-03 |
| 1083879399 | Tyler Physicians, P.a. | Clinic/Center | 10202 W 13th St N, Wichita, KS 67212-4377 | 2008-07-25 |
| 1063453991 | Ascension Medical Group Via Christi, Pa | Clinic/Center | 3311 E Murdock St, Wichita, KS 67208 | 2006-06-10 |
| 1730153008 | Wichita Psychiatric Consultants LLC | Clinic/Center | 9415 East Harry, Bldg 800, Wichita, KS 67207-5072 | 2006-02-14 |
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| 1023627940 | Arena Health LLC | Clinic/Center | 8010 Stateline Road, Suite 100, Prairie Village, KS 66208 | 2020-07-27 |
| 1992326755 | M P Network LLC | Clinic/Center | 500 N Main St Ste 100, Newton, KS 67114-2200 | 2020-05-04 |
| 1457833378 | Chs Tennessee Medical P C | Clinic/Center | 2200 Nw Brickyard Rd, Topeka, KS 66618-2814 | 2018-09-06 |
| 1669905139 | Serc Rehabilitation Partners LLC | Clinic/Center | 2108 W 27th St, Ste K, Lawrence, KS 66047-3153 | 2017-04-11 |
| 1871969865 | Jefferson County Memorial Hospital | Clinic/Center | 15630 Pinehurst Dr, Suite 5, Basehor, KS 66007-8233 | 2015-08-13 |
| 1447660360 | Jefferson County Memorial Hospital | Clinic/Center | 504 Plaza Dr, Suite 300, Perry, KS 66073-4136 | 2014-04-30 |
| 1861823403 | Serc Rehabilitation Partners LLC | Clinic/Center | 3627 Se 29th St, Ste 107, Topeka, KS 66605-2013 | 2013-12-09 |
| 1427312818 | Serc Rehabilitation Partners, LLC | Clinic/Center | 5799 Broadmoor St Ste 300, Mission, KS 66202-2421 | 2012-06-29 |
| 1184922981 | Allen Physicians LLC | Clinic/Center | 1715 Medical Pkwy, Suite 110, Newton, KS 67114-8940 | 2011-03-03 |
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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.