GLEN SHURTZ (NPI# 1558339317) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558339317 |
| Entity Type | Individual |
| Full Name | GLEN SHURTZ |
| Credential | MD |
| 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 | 2012-05-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2085B0100X |
Radiology Specialization: Body Imaging |
04-19424 | KS | Allopathic & Osteopathic Physicians |
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
04-19424 | KS | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KS | 100127010C | 05 | |
| KS | BCBS | 103239 | 01 |
| RAILROAD MEDICARE | P00063431 | 01 | |
| TRICARE | 515406770 | 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 |
| 1245208008 | Prairie Creek Imaging LLC | 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 | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205335551 | Elias O Bernard | Radiology | 6505 E Central Ave Ste 208, Wichita, KS 67206-1924 | 2018-02-01 |
| 1760627616 | Gdx, P.a. | Radiology | 6120 Shadybrook St, Wichita, KS 67208-1862 | 2008-12-06 |
| 1609940675 | Wayne Mason | Radiology | 701 N Preston Trl, Wichita, KS 67230-1525 | 2006-11-20 |
| 1629162326 | Great Plains Imaging, LLC | Radiology | 8925 W Maple St, Wichita, KS 67209-1462 | 2006-10-03 |
| 1841209236 | Paul L Rodriguez | Radiology | 4713 N Portwest Cir, Wichita, KS 67204-2356 | 2006-08-05 |
| 1376507590 | Line Diagnostics Inc | Radiology | 630 S Hillside St, Wichita, KS 67211-2157 | 2006-04-14 |
| 1225034614 | Claudia A Lawn | Radiology | 144 S Hillside St, Wichita, KS 67211-2154 | 2005-06-22 |
| 1013913490 | Akash C. Joshi | Radiology | 551 N Hillside St, Ste 320, Wichita, KS 67214-4926 | 2005-06-22 |
| 1790321479 | Anthony Francis Harrison | Radiology | 929 N Saint Francis Ave, Wichita, KS 67214-3821 | 2019-11-18 |
| 1255894580 | Jimmy Rong | Radiology | 1010 N Kansas St Ste 3023, Wichita, KS 67214-3124 | 2019-04-12 |
| 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.