GRACEMED HEALTH CLINIC, INC (NPI# 1659631695) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659631695 |
| Entity Type | Organization |
| Organization Name | GRACEMED HEALTH CLINIC, INC |
| Other Organization Name | GRACEMED GOOD SAMARITAN CLINIC |
| Practice Address |
3701 E 13th St N Wichita KS 67208-2086 |
| 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 |
| Other Name | Type Code |
|---|---|
| GraceMed Good Samaritan 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 |
3701 E 13TH ST N |
| City | WICHITA |
| State | KS |
| Zip Code | 67208-2086 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770536401 | The Good Samaritan-a Family Health Care Facility, Inc | Family Medicine | 3701 E 13th St N, Wichita, KS 67208-2080 | 2006-05-17 |
| 1568989341 | Gail L Boaldin | Nurse Practitioner | 3701 E 13th St N, Wichita, KS 67208-2014 | 2017-08-23 |
| 1023258266 | World Impact, Inc. | Family Medicine | 3701 E 13th St N, #400, Wichita, KS 67208-2086 | 2009-02-28 |
| 1629273875 | Dee Ann Bragg | Family Medicine | 3701 E 13th St N, Wichita, KS 67208-2086 | 2007-06-18 |
| 1134336407 | Ralph Bubeck | Internal Medicine | 3701 E 13th St N, #400, Wichita, KS 67208-2086 | 2007-05-17 |
| 1477678308 | Isela Hurtig | Physician Assistant | 3701 E 13th St N, Wichita, KS 67208 | 2007-03-20 |
| 1952406431 | Jennifer A. Sebes | Registered Nurse | 3701 E 13th St N, Wichita, KS 67208-2004 | 2006-09-13 |
| 1063448678 | Fariba Behzadpour | Family Medicine | 3701 E 13th St N, Wichita, KS 67208-2086 | 2006-06-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598316218 | Wesley Urgent Care, LLC | Clinic/Center | 2060 N. Mid Campus Dr., Wichita, KS 67208 | 2019-09-24 |
| 1023574209 | Unified Care Homes, Inc. | Custodial Care Facility | 5705 E Rockhill, Wichita, KS 67208 | 2019-02-13 |
| 1164940730 | Donita Hock | Occupational Therapy Assistant | 622 N. Edgemoor St., Wichita, KS 67208 | 2017-09-05 |
| 1427439546 | Mental Health Association of Sck | Community/Behavioral Health | 555 N Woodlawn, S 3105, Wichita, KS 67208 | 2015-06-15 |
| 1013311430 | Adrian Matta | Occupational Therapy Assistant | 1915 Farmstead Street, Wichita, KS 67208 | 2014-10-14 |
| 1700285343 | Stephanie Kendrick | Physical Therapist | 4921 E. 21st Street North, Wichita, KS 67208 | 2014-08-20 |
| 1689087942 | Apeksha Sathyaprasad | Pediatrics | 3243 E Murdock St Ste 402, Wichita, KS 67208 | 2014-06-04 |
| 1437418019 | J. W, Leisy M.d.p.a. | Psychiatry & Neurology | 3310 East Douglas #101, Wichita, KS 67208 | 2012-05-16 |
| 1184993156 | College Hill-ltc LLC | Skilled Nursing Facility | 5005 East 21st Street North, Wichita, KS 67208 | 2011-12-21 |
| 1255616132 | Thane M Vaneaton | Pharmacist | 3333 East Central, Wichita, KS 67208 | 2011-10-11 |
| Find all providers in zip 67208 | ||||
| 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.