GRACEMED HEALTHY FAMILY CLINIC


Address: 1905 S Laura St, Wichita, KS 67211-4422
Phone: 3168662000

GRACEMED HEALTHY FAMILY CLINIC (NPI# 1356777114) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1356777114
Entity Type Organization
Organization Name GRACEMED HEALTHY FAMILY CLINIC
Practice Address 1905 S Laura St
Wichita
KS 67211-4422
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 2013-09-24
Last Update Date 2013-09-24
Authorized Official Name MR. DAVID C SANFORD (CEO)
Authorized Official Telephone 3168662001
Is Organization Subpart Y
Parent Organization Name GRACEMED HEALTH CLINIC, INC

Taxonomy

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 Provider Identifier

State Issuer Identifier Type Code
KS 100212250A 05

Office Location

Street Address 1905 S LAURA ST
City WICHITA
State KS
Zip Code 67211-4422

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1841628013 Joseph Michael Stech Family Medicine 940 S. St. Francis, Guadalupe Clinic, Wichita, KS 67211 2013-10-24
1902166648 Debby Elwood Counselor 830 S. Hillside, Wichita, KS 67211 2012-05-28
1205038726 Patricia (pat) J. Eagleman Social Worker 333 S. Greenwood, Wichita, KS 67211 2007-06-05
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Taxonomy Information

Taxonomy Code 261QF0400X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Federally Qualified Health Center (FQHC)

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

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
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
1861859787 Gracemed Health Clinic, Inc Clinic/Center 1919 N Amidon Ave, Suite 100, Wichita, KS 67203-2117 2016-01-22
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Competitor

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City WICHITA
Zip Code 67211

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Dataset Information

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.

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