PRAIRIE CREEK IMAGING LLC (NPI# 1245208008) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245208008 |
| Entity Type | Organization |
| Organization Name | PRAIRIE CREEK IMAGING LLC |
| Practice Address |
500 S Main St Wichita KS 67202-3722 |
| Mailing Address |
Po Box 2854 Wichita KS 67201-2854 |
| Practice Telephone | 3162621103 |
| Mailing Telephone | 3166853698 |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | GLEN SHURTZ (PRESIDENT) |
| Authorized Official Telephone | 3162621103 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 2085B0100X |
Radiology Specialization: Body Imaging |
Allopathic & Osteopathic Physicians | ||
| X | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KS | BCBS | 110957 | 01 |
| RAILROAD MEDICARE | DA5653 | 01 |
| Street Address |
500 S MAIN ST |
| City | WICHITA |
| State | KS |
| Zip Code | 67202-3722 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417912221 | Premier Pet Imaging of Wichita Inc | Clinic/Center | 500 S Main St, Suite B, Wichita, KS 67202-3722 | 2006-04-18 |
| 1558339317 | Glen Shurtz | Radiology | 500 S Main St, Wichita, KS 67202-3722 | 2006-03-09 |
| 1457343204 | Premier Open Mri, Inc. | Clinic/Center | 500 S Main St, Wichita, KS 67202-3722 | 2005-08-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245845338 | Raneisha Hunter | Marriage & Family Therapist | 622 E. Douglasave, Wichita, KS 67202 | 2020-09-15 |
| 1104397124 | Bridges Healthcare Inc | Clinic/Center | 313 S. Market Street, Wichita, KS 67202 | 2018-12-17 |
| 1043712912 | Creative Bliss Therapy | Counselor | 115 Waterman Street, Wichita, KS 67202 | 2018-03-06 |
| 1720596240 | Sunheart Holistic, LLC | Social Worker | 200 N Broadway Ave Ste 535, Wichita, KS 67202 | 2018-01-18 |
| 1912423823 | Jenni Harshbarger, Phd, P.a. | Clinic/Center | 801 E. Douglas, Regus Suites, 2nd Floor, Wichita, KS 67202 | 2017-08-22 |
| 1336695287 | The Young Men's Christian Association of Wichita, Kansas | Health Educator | 402 N Market St, Wichita, KS 67202 | 2016-08-31 |
| 1699103739 | Nadine Reimer Penner | Social Worker | 313 S Market Street, Wichita, KS 67202 | 2013-10-29 |
| 1386992691 | Andrea Lynn Kasper-doggett | Social Worker | 100 S Market St Ste 2a, Wichita, KS 67202 | 2012-08-16 |
| 1679883318 | Carol Ann Knott | Registered Nurse | 909 N. Emporia, Wichita, KS 67202 | 2010-10-15 |
| 1851539431 | Peter Anthony Conrardy | Anesthesiology | 224 E. Douglas Ave., Suite 400 C/o Anesthesia Consulting Services, Wichita, KS 67202 | 2009-02-04 |
| Find all providers in zip 67202 | ||||
| Taxonomy Code | 2085B0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Body Imaging |
| A Radiology doctor of Osteopathy that specializes in Body Imaging. |
| Notes: Source: National Uniform Claim Committee, 2008 [7/1/2008: definiton added, source added] Additional Resources: The American Osteopathic Board of Radiology no longer offers a certificate in this specialty. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346700382 | Rizwan Mohiuddin Zafer | Radiology | 1010 N Kansas St, Wichita, KS 67214-3124 | 2019-03-25 |
| 1598145005 | Ascension Via Christi Imaging Wichita, LLC | Radiology | 3600 E Harry St, Wichita, KS 67218-3713 | 2015-06-01 |
| 1528036399 | Imaging Corporation of Wichita Pa | Radiology | 3333 N Webb Rd, Wichita, KS 67226-8123 | 2006-03-09 |
| 1558339317 | Glen Shurtz | Radiology | 500 S Main St, Wichita, KS 67202-3722 | 2006-03-09 |
| 1558339325 | Norman Pay | Radiology | 3333 N Webb Rd, Wichita, KS 67226-8123 | 2006-03-09 |
| 1831166537 | Ams Diagnostics, LLC | Radiology | 1035 N Emporia St, Suite 215, Wichita, KS 67214-2944 | 2006-03-02 |
| 1376526327 | James C Degner | Radiology | 3600 E Harry St, Wichita, KS 67218-3713 | 2005-11-23 |
| 1861475048 | Robert A Schmaltz | Radiology | 929 N Saint Francis St, Wichita, KS 67214-3821 | 2005-11-22 |
| 1508849787 | Suryakumar Reddy | Radiology | 929 N Saint Francis St, Wichita, KS 67214-3821 | 2005-11-22 |
| 1871575274 | Thomas D Cox | Radiology | 929 N Saint Francis St, Wichita, KS 67214-3821 | 2005-11-19 |
| 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.