LARRY M PANKOW (NPI# 1568446797) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568446797 |
| Entity Type | Individual |
| Full Name | LARRY M PANKOW |
| Credential | MD |
| Practice Address |
9333 East 21st. St., North Wichita KS 67206-2927 |
| Practice Telephone | 3166344700 |
| Practice Fax Number | 3166344770 |
| Mailing Telephone | 3166344700 |
| Mailing Fax Number | 3166344770 |
| Enumeration Date | 2005-12-01 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0805X |
Psychiatry & Neurology Specialization: Geriatric Psychiatry |
0420959 | KS | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | DEA LICENSE # | BP 0267030 | 01 |
| Street Address |
9333 EAST 21ST. ST., NORTH |
| City | WICHITA |
| State | KS |
| Zip Code | 67206-2927 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548242068 | Mervin L Bontrager | Social Worker | 9333 East 21st. St., North, Wichita, KS 67206-2927 | 2005-11-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760020846 | Founders Surgery Center, LLC | Clinic/Center | 1961 N Founders Circle, Wichita, KS 67206 | 2019-12-19 |
| 1174006613 | Courtney Dawn Simon | Physical Therapist | 9360 E Central Ave Ste 100, Wichita, KS 67206 | 2018-09-11 |
| 1902308919 | Center At Waterfront LLC | Skilled Nursing Facility | 1541 North Lindberg Circle, Wichita, KS 67206 | 2018-03-06 |
| 1750804597 | Katelyn Aguiar | Psychologist | 250 N Rock Rd Ste 210, Wichita, KS 67206 | 2017-07-24 |
| 1457888778 | Mona Kay Cherryholmes | Social Worker | 1223 N. Rock Rd, Bldg A. Suite 100, Wichita, KS 67206 | 2017-05-17 |
| 1164899415 | Elizabeth Herl | Marriage & Family Therapist | 250 N Rock Rd Ste 150, Wichita, KS 67206 | 2015-08-21 |
| 1851715510 | Ndjj Corp | Custodial Care Facility | 6403 E Marjore, Wichita, KS 67206 | 2014-02-14 |
| 1801238217 | Courtney Ann Lang | Physical Therapist | 1603 North Chapel Hill Street, Suite 400, Wichita, KS 67206 | 2013-07-26 |
| 1194063032 | Peak Performance Health Pa | Chiropractor | 10111 E 21st St, #106, Wichita, KS 67206 | 2013-01-28 |
| 1750629002 | Rachel Marie Conrad | Speech-Language Pathologist | 1861 N. Rock Rd, Ste 101, Wichita, KS 67206 | 2013-01-22 |
| Find all providers in zip 67206 | ||||
| Taxonomy Code | 2084P0805X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Geriatric Psychiatry |
| Geriatric Psychiatry is a subspecialty with psychiatric expertise in prevention, evaluation, diagnosis and treatment of mental and emotional disorders in the elderly, and improvement of psychiatric care for healthy and ill elderly patients. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962740449 | Brighter Day Health LLC | Psychiatry & Neurology | 1045 Stone Creek Dr, Lawrence, KS 66049-4777 | 2013-01-17 |
| 1831498492 | Hays Medical Center, Inc | Psychiatry & Neurology | 2214 Canterbury Dr Ste 300, Hays, KS 67601 | 2011-03-22 |
| 1659546968 | Carolina Aponte Urdaneta | Psychiatry & Neurology | 4200 Somerset Dr, Suite 214, Prairie Village, KS 66208-5217 | 2008-04-28 |
Please comment or provide details below to improve the information on LARRY M PANKOW.
| 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.