GRACEMED HEALTH CLINIC, INC (NPI# 1275893224) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275893224 |
| Entity Type | Organization |
| Organization Name | GRACEMED HEALTH CLINIC, INC |
| Other Organization Name | GRACEMED MOTHER MARY ANNE CLINIC |
| Practice Address |
1131 S Clifton Ave Wichita KS 67218-2955 |
| 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 | 2012-05-24 |
| Last Update Date | 2012-10-16 |
| 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 |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KS | 100212250R | 05 |
| Other Name | Type Code |
|---|---|
| GraceMed Mother Mary Anne 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 |
| 1053770818 | Gracemed Health Clinic, Inc | Clinic/Center | 3417 S Meridian Ave, Wichita, KS 67217-2151 | 2016-02-22 |
| 1861859787 | Gracemed Health Clinic, Inc | Clinic/Center | 1919 N Amidon Ave, Suite 100, Wichita, KS 67203-2117 | 2016-01-22 |
| Street Address |
1131 S CLIFTON AVE |
| City | WICHITA |
| State | KS |
| Zip Code | 67218-2955 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063416048 | Robert Lamar Eyster | Orthopaedic Surgery | 1131 S Clifton Ave, Wichita, KS 67218-2955 | 2005-06-08 |
| 1023476694 | Kevin L Brown | Nurse Practitioner | 1131 S Clifton Ave, Suite B, Wichita, KS 67218-2955 | 2016-02-10 |
| 1932500782 | Jill N Makuka | Physician Assistant | 1131 S Clifton Ave, Suite B, Wichita, KS 67218-2955 | 2014-09-11 |
| 1275973455 | Sonya L. Bradford-varner | Nurse Practitioner | 1131 S Clifton Ave, Wichita, KS 67218-2955 | 2013-07-02 |
| 1255679809 | Mary Brost | Nurse Practitioner | 1131 S Clifton Ave, Suite B, Wichita, KS 67218-2955 | 2013-01-16 |
| 1891044376 | Stephanie April Collins | Nurse Practitioner | 1131 S Clifton Ave, Suite B, Wichita, KS 67218-2955 | 2012-08-30 |
| 1871872804 | Lisa Marie Farrell | Nurse Practitioner | 1131 S Clifton Ave, Wichita, KS 67218-2955 | 2011-08-08 |
| 1083918643 | Elizabeth Evans | Nurse Practitioner | 1131 S Clifton Ave, Wichita, KS 67218-2955 | 2010-12-22 |
| 1245551035 | Erika J Burke | Family Medicine | 1131 S Clifton Ave, Wichita, KS 67218-2955 | 2010-06-16 |
| 1316179849 | Daniel Reimer | Family Medicine | 1131 S Clifton Ave, Wichita, KS 67218-2955 | 2009-08-17 |
| Find all providers in the same location | ||||
| 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 | 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 |
| 1053770818 | Gracemed Health Clinic, Inc | Clinic/Center | 3417 S Meridian Ave, Wichita, KS 67217-2151 | 2016-02-22 |
| 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.