MR. SHAWN C VREDENBURG (NPI# 1194079277) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194079277 |
| Entity Type | Individual |
| Full Name | MR. SHAWN C VREDENBURG |
| Credential | PA |
| Practice Address |
3311 E Murdock St Wichita KS 67208-3054 |
| Mailing Address |
1121 S Dodge Ave Wichita KS 67213-4436 |
| Practice Telephone | 3166899107 |
| Mailing Telephone | 3166178546 |
| Enumeration Date | 2012-10-29 |
| Last Update Date | 2012-11-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | T03473 | KS | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3311 E MURDOCK ST |
| City | WICHITA |
| State | KS |
| Zip Code | 67208-3054 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811987324 | Bushra Sulieman | Internal Medicine | 3311 E Murdock St, Wichita, KS 67208-3054 | 2005-10-26 |
| 1770057812 | Hannah Roth | Physician Assistant | 3311 E Murdock St, Wichita, KS 67208-3054 | 2019-01-11 |
| 1881167682 | Megan Theresa Poell | Registered Nurse | 3311 E Murdock St, Wichita, KS 67208 | 2019-01-04 |
| 1629552484 | Nichole L Fischer | Nurse Practitioner | 3311 E Murdock St, Wichita, KS 67208-3054 | 2018-09-18 |
| 1215436647 | Joshua Cody Forsberg | Nurse Practitioner | 3311 E Murdock St, Wichita, KS 67208-3054 | 2018-02-12 |
| 1619484540 | Kelsey Olson | Licensed Practical Nurse | 3311 E Murdock St, Wichita, KS 67208-3054 | 2017-12-31 |
| 1174045520 | Genevieve Jo Gutierrez Davis | Nurse Practitioner | 3311 E Murdock St, Wichita, KS 67208-3054 | 2017-07-07 |
| 1013374990 | Ascension Medical Group Via Christi, Pa | Radiology | 3311 E Murdock St, Wichita, KS 67208-3054 | 2016-01-22 |
| 1013372671 | Krista Fischer | Nurse Practitioner | 3311 E Murdock St, Wichita, KS 67208-3054 | 2015-12-28 |
| 1639544992 | Tressie Maugans | Nurse Practitioner | 3311 E Murdock St, Wichita, KS 67208-3054 | 2015-12-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598316218 | Wesley Urgent Care, LLC | Clinic/Center | 2060 N. Mid Campus Dr., Wichita, KS 67208 | 2019-09-24 |
| 1023574209 | Unified Care Homes, Inc. | Custodial Care Facility | 5705 E Rockhill, Wichita, KS 67208 | 2019-02-13 |
| 1164940730 | Donita Hock | Occupational Therapy Assistant | 622 N. Edgemoor St., Wichita, KS 67208 | 2017-09-05 |
| 1427439546 | Mental Health Association of Sck | Community/Behavioral Health | 555 N Woodlawn, S 3105, Wichita, KS 67208 | 2015-06-15 |
| 1013311430 | Adrian Matta | Occupational Therapy Assistant | 1915 Farmstead Street, Wichita, KS 67208 | 2014-10-14 |
| 1700285343 | Stephanie Kendrick | Physical Therapist | 4921 E. 21st Street North, Wichita, KS 67208 | 2014-08-20 |
| 1689087942 | Apeksha Sathyaprasad | Pediatrics | 3243 E Murdock St Ste 402, Wichita, KS 67208 | 2014-06-04 |
| 1437418019 | J. W, Leisy M.d.p.a. | Psychiatry & Neurology | 3310 East Douglas #101, Wichita, KS 67208 | 2012-05-16 |
| 1184993156 | College Hill-ltc LLC | Skilled Nursing Facility | 5005 East 21st Street North, Wichita, KS 67208 | 2011-12-21 |
| 1255616132 | Thane M Vaneaton | Pharmacist | 3333 East Central, Wichita, KS 67208 | 2011-10-11 |
| Find all providers in zip 67208 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871116582 | Alia Porter | Physician Assistant | 115 N Terrace Dr, Wichita, KS 67208-3941 | 2020-05-28 |
| 1881217594 | Taylor Nicole Wondra | Physician Assistant | 1845 N Woodrow Ct, Wichita, KS 67203-2959 | 2020-05-28 |
| 1497378087 | Haley Nicole Northcutt | Physician Assistant | 10107 W Jamesburg St, Wichita, KS 67212-6743 | 2020-05-18 |
| 1649892357 | Mong Trinh Thi Hoang | Physician Assistant | 1933 N Wellington Pl, Wichita, KS 67203-2558 | 2020-05-15 |
| 1609434000 | Branden Tang | Physician Assistant | 10112 E Clark St, Wichita, KS 67207-7747 | 2019-05-31 |
| 1184093379 | Evan C Ohlman | Physician Assistant | 3009 N Cypress, Wichita, KS 67226-4003 | 2015-09-18 |
| 1629388079 | Sara A Hildreth | Physician Assistant | 9415 E Harry St Ste 202, Wichita, KS 67207-5076 | 2010-10-19 |
| 1477700235 | Heather S Bloomer | Physician Assistant | 2465 N Woodridge Ct, Wichita, KS 67226-8208 | 2008-08-25 |
| 1205030145 | William Paul Wondra | Physician Assistant | 141 W Elm St, Sedgwick County Detention Facility, Wichita, KS 67203-3848 | 2007-06-13 |
| 1194888602 | Vicki L Gromala | Physician Assistant | 1861 N. Road Road, Suite 105, Wichita, KS 67206-1264 | 2006-12-18 |
| Find all providers in WICHITA | ||||
Please comment or provide details below to improve the information on MR. SHAWN C VREDENBURG.
| 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.