GREGORY M. KNOBLAUCH (NPI# 1902844483) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902844483 |
| Entity Type | Individual |
| Full Name | GREGORY M. KNOBLAUCH |
| Credential | PA-C |
| Practice Address |
10100 E Shannon Woods St Suite 100 Wichita KS 67226-4104 |
| Practice Telephone | 3162198299 |
| Practice Fax Number | 3162195899 |
| Mailing Telephone | 3162198299 |
| Mailing Fax Number | 3162195899 |
| Enumeration Date | 2006-06-04 |
| Last Update Date | 2017-04-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
15-00484 | KS | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KS | PREFERRED HEALTH SYSTEMS | 4840 | 01 |
| KS | BLUE SHIELD | 042940 | 01 |
| KS | 100357590C | 05 | |
| R. R. MEDICARE | 970028120 | 01 | |
| KS | FIRST GUARD | 662341 | 01 |
| Street Address |
10100 E SHANNON WOODS ST SUITE 100 |
| City | WICHITA |
| State | KS |
| Zip Code | 67226-4104 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811979271 | Mark Camden Whitaker | Orthopaedic Surgery | 10100 E Shannon Woods St, Suite 100, Wichita, KS 67226-4104 | 2005-11-18 |
| 1578118592 | Kelsey Jacobs | Physical Therapy Assistant | 10100 E Shannon Woods St, Wichita, KS 67226-4104 | 2019-08-06 |
| 1720573058 | Kristina Marie Underhill | Physical Therapist | 10100 E Shannon Woods St, Wichita, KS 67226-4104 | 2018-06-28 |
| 1164892675 | Elizabeth Hayes | Physician Assistant | 10100 E Shannon Woods St, Suite 100, Wichita, KS 67226-4104 | 2015-09-28 |
| 1992119457 | Daniel Quillin | Physical Therapist | 10100 E Shannon Woods St, Wichita, KS 67226-4104 | 2014-06-12 |
| 1295161792 | Bree A Greer | Nurse Practitioner | 10100 E Shannon Woods St, Suite 100, Wichita, KS 67226-4104 | 2013-09-17 |
| 1467891036 | Rachel Leanne Schmidt | Physical Therapist | 10100 E Shannon Woods St, Wichita, KS 67226-4103 | 2013-06-17 |
| 1720206105 | Damion Y Walker | Orthopaedic Surgery | 10100 E Shannon Woods St, Suite 100, Wichita, KS 67226-4104 | 2007-04-23 |
| 1790815835 | Robert C Manske | Physical Therapist | 10100 E Shannon Woods St, Wichita, KS 67226-4103 | 2007-03-07 |
| 1922016492 | Kansas Joint & Spine Specialists, LLC | Durable Medical Equipment & Medical Supplies | 10100 E Shannon Woods St, Suite 100, Wichita, KS 67226-4104 | 2006-08-03 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386111649 | Kansas Diabetes and Endocrinology Center LLC | Clinic/Center | 3161 N Webb Rd, Suite 200, Wichita, KS 67226 | 2018-10-25 |
| 1619474020 | Village Dentistry, Pa | Dentist | 2222 N. Greenwich, Suite 400, Wichita, KS 67226 | 2018-04-11 |
| 1861910408 | Lindsay Beth Kachelmeier | Marriage & Family Therapist | 6525 E Mainsgate, Wichita, KS 67226 | 2017-09-04 |
| 1659800084 | Doris Kimbrell | Clinical Nurse Specialist | 8200 East Thorn, Wichita, KS 67226 | 2017-06-08 |
| 1467986836 | Megan Elizabeth Couey | Counselor | 8623 E 32nd St. N, Suite 100, Wichita, KS 67226 | 2017-04-12 |
| 1306298922 | Wilson Yip | Dentist | 2222 N Greenwich Rd, Wichita, KS 67226 | 2016-07-07 |
| 1396102315 | Healthy Balance Center, LLC | Marriage & Family Therapist | 8100 E 22nd St. North, #1800-2, Wichita, KS 67226 | 2016-01-21 |
| 1851775142 | Cardiac Cath Lab of Wichita Lp | Clinic/Center | 3555 North Webb Rd., Suite A, Wichita, KS 67226 | 2015-07-16 |
| 1114334067 | Jane Crawford | Nurse Practitioner | 8623 E 32nd St N, Wichita, KS 67226 | 2014-07-11 |
| 1801202882 | Erin Kellie Jeffress | Occupational Therapy Assistant | 3500 N Rock Rd, Building 2200, Ste 101, Wichita, KS 67226 | 2014-07-10 |
| Find all providers in zip 67226 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962435552 | Gregory Bryan De Laney | Physician Assistant | 1431 Bluffview St Ste 210, Wichita, KS 67218-3039 | 2006-07-08 |
| 1770057812 | Hannah Roth | Physician Assistant | 3311 E Murdock St, Wichita, KS 67208-3054 | 2019-01-11 |
| 1235621947 | Tiana Alani Goering | Physician Assistant | 550 N Hillside St, Wichita, KS 67214-4910 | 2018-05-30 |
| 1164892675 | Elizabeth Hayes | Physician Assistant | 10100 E Shannon Woods St, Suite 100, Wichita, KS 67226-4104 | 2015-09-28 |
| 1205905726 | Brian S. Zerger | Physician Assistant | 1923 N Webb Rd, Wichita, KS 67206-3405 | 2006-11-07 |
| 1063428811 | Peter S Vang | Physician Assistant | 9300 E 29th St N, Suite 205, Wichita, KS 67226-2182 | 2006-08-01 |
| 1558389726 | Randall Eugene Ford | Physician Assistant | 5500 E Kellogg Dr, Wichita, KS 67218-1607 | 2006-07-17 |
| 1114950706 | Jerrod A. Conkling | Physician Assistant | 3223 N Webb Rd, Suite 1, Wichita, KS 67226-8175 | 2006-07-08 |
| 1962447920 | Larry Dean Armstrong | Physician Assistant | 5500 E Kellogg Dr, Wichita, KS 67218-1607 | 2006-06-16 |
| 1699712950 | Michael R. Easter | Physician Assistant | 10100 E Shannon Woods St, Suite 100, Wichita, KS 67226-4104 | 2006-06-02 |
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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.