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).
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 |
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 | 100212250A | 05 |
Street Address |
1905 S LAURA ST |
City | WICHITA |
State | KS |
Zip Code | 67211-4422 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1386162683 | Karlee Dawn Gluszek | Specialist/Technologist | 1947 S Lulu St, Wichita, KS 67211 | 2017-09-07 |
1780139659 | Jaclyn Blyholder | Dentist | 639 S. Hillside, Wichita, KS 67211 | 2016-08-22 |
1356715379 | Revitalize Physical Therapy LLC | Physical Therapist | 227 S Ida St, Wichita, KS 67211 | 2015-11-16 |
1750753232 | Accurate Sleep Lab | Clinical Medical Laboratory | 411 S Pattie St Suite 2, Wichita, KS 67211 | 2015-10-23 |
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 |
1114147717 | Rodolfo A Argosino Md Pa | Family Medicine | 1148 S Hillside, 106, Wichita, KS 67211 | 2007-04-26 |
1801911086 | Susan Wright Rockley | Physical Therapist | 2535 East Lincoln, Wichita, KS 67211 | 2007-03-20 |
1578618021 | Dependable Assisted Living | Home Health | 401 S Greenwood St, Wichita, KS 67211 | 2007-01-24 |
Find all providers in zip 67211 |
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 |
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 |
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.