GRACEMED HEALTH CLINIC, INC (NPI# 1053770818) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053770818 |
| Entity Type | Organization |
| Organization Name | GRACEMED HEALTH CLINIC, INC |
| Other Organization Name | GRACEMED VIRGINIA & GEORGE ABLAH FAMILY CLINIC |
| Practice Address |
3417 S Meridian Ave Wichita KS 67217-2151 |
| 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 | 2016-02-22 |
| Last Update Date | 2017-04-25 |
| Authorized Official Name | MR. DAVID C SANFORD (CEO) |
| Authorized Official Telephone | 3168662001 |
| Is Organization Subpart | N |
| 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 Name | Type Code |
|---|---|
| GraceMed Virginia & George Ablah Family Clinic | Doing Business As Name - Organization |
| 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 |
| 1952651713 | Gracemed Health Clinic, Inc | Clinic/Center | 4910 W 1st St N, Wichita, KS 67212-2341 | 2012-09-19 |
| 1568947737 | Gracemed Health Clinic, Inc | Clinic/Center | 101 E Ross St, Clearwater, KS 67026-7824 | 2018-10-03 |
| 1437697174 | Gracemed Health Clinic, Inc | Pharmacy | 1122 N Topeka St, Wichita, KS 67214-2810 | 2017-02-02 |
| 1871035709 | Gracemed Health Clinic, Inc | Clinic/Center | 322 N Main St, Suite 100, Mcpherson, KS 67460-4308 | 2016-11-09 |
| 1285083469 | Gracemed Health Clinic, Inc | Clinic/Center | 2025 Se California Ave, Topeka, KS 66607-1443 | 2016-06-08 |
| 1194174482 | Gracemed Health Clinic, Inc | Clinic/Center | 1615 Sw 8th Ave, Topeka, KS 66606-1633 | 2016-06-07 |
| 1861859787 | Gracemed Health Clinic, Inc | Clinic/Center | 1919 N Amidon Ave, Suite 100, Wichita, KS 67203-2117 | 2016-01-22 |
| 1730575069 | Gracemed Health Clinic, Inc | Clinic/Center | 3610 E Ross Pkwy, Wichita, KS 67210-1311 | 2015-04-14 |
| Street Address |
3417 S MERIDIAN AVE |
| City | WICHITA |
| State | KS |
| Zip Code | 67217-2151 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659429116 | Jamie L Speth | Optometrist | 3417 S Meridian Ave, Wichita, KS 67217-2151 | 2007-01-08 |
| 1568957629 | Drew T Nuckolls | Dentist | 3417 S Meridian Ave, Wichita, KS 67217-2151 | 2018-06-29 |
| 1538689229 | Shonda Lynn Colella | Nurse Practitioner | 3417 S Meridian Ave, Wichita, KS 67217-2151 | 2017-06-22 |
| 1124417548 | Tammy Brewer | Nurse Practitioner | 3417 S Meridian Ave, Wichita, KS 67217-2151 | 2015-01-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922383736 | Patti Jean Rogers | Pharmacist | 3150 S Seneca, Wichita, KS 67217 | 2011-10-13 |
| 1447275573 | Richard L Dopps | Chiropractor | 1001 W 47th St S, Wichita, KS 67217 | 2006-07-12 |
| 1093755811 | Dillon Companies LLC | Pharmacy | 3211 S Seneca St, Wichita, KS 67217 | 2006-06-08 |
| 1235191917 | Robert Charles Beaver | Dentist | 2860 S Seneca, Suite A, Wichita, KS 67217 | 2006-04-06 |
| 1134182686 | Twietmeyer Dentistry Pa | Dentist | 3920 W 31st St S, Wichita, KS 67217-1112 | 2006-04-07 |
| 1053763714 | Charles Twietmeyer | Dentist | 3920 W 31st St S, Wichita, KS 67217-1112 | 2016-07-06 |
| 1306047634 | Kate E Rohr | Dentist | 3920 W 31st St S, Wichita, KS 67217-1112 | 2007-05-31 |
| 1568748903 | Michael Shirkey | Marriage & Family Therapist | 1903 W Anita Ave, Wichita, KS 67217-1801 | 2011-10-31 |
| 1558542035 | David M. Guerrero | Dentist | 3027 S Hiram Ave, Wichita, KS 67217-1938 | 2007-11-26 |
| 1285922658 | Kimberley R. Jones | Social Worker | 3450 S Bonn Ave, Wichita, KS 67217-2136 | 2011-07-19 |
| Find all providers in zip 67217 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| 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 |
| 1912333774 | Gracemed Evergreen Family Clinic | Clinic/Center | 2700 N Woodland St, Wichita, KS 67204-5158 | 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 |
| 1861859787 | Gracemed Health Clinic, Inc | Clinic/Center | 1919 N Amidon Ave, Suite 100, Wichita, KS 67203-2117 | 2016-01-22 |
| 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.