Katie's Way, Llc | |
720 Poyntz Ave Manhattan KS 66502-6355 | |
(785) 320-7331 | |
(785) 320-7338 |
Full Name | Katie's Way, Llc |
---|---|
Speciality | Psychiatry & Neurology |
Location | 720 Poyntz Ave, Manhattan, Kansas |
Authorized Official Name and Position | Kelly Rae Johnson (BILLING DIRECTOR) |
Authorized Official Contact | 7853206616 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Katie's Way, Llc 720 Poyntz Ave Manhattan KS 66502-6355 Ph: (785) 320-7331 | Katie's Way, Llc 720 Poyntz Ave Manhattan KS 66502-6355 Ph: (785) 320-7331 |
NPI Number | 1881096428 |
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Provider Enumeration Date | 09/25/2014 |
Last Update Date | 07/12/2024 |
Certification Date | 07/12/2024 |
Medicare PECOS PAC ID | 1254664279 |
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Medicare Enrollment ID | O20190606001608 |
Identifier | Type | State | Issuer |
---|---|---|---|
1881096428 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
Provider Name | Jeffrey C Mathis |
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Provider Type | Practitioner - Occupational Therapist In Private Practice |
Provider Identifiers | NPI Number: 1861504755 PECOS PAC ID: 8729992102 Enrollment ID: I20050401000893 |
Provider Name | David Wichman |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1760695290 PECOS PAC ID: 2062585805 Enrollment ID: I20080726000094 |
Provider Name | Kendra M Smith |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1265576805 PECOS PAC ID: 4981747284 Enrollment ID: I20100209000592 |
Provider Name | Taylor L Porter |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1760423362 PECOS PAC ID: 0446381081 Enrollment ID: I20100626000198 |
Provider Name | Judith A Bunting |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1750687588 PECOS PAC ID: 6002092269 Enrollment ID: I20110524000273 |
Provider Name | Maria E Ellis |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1033157094 PECOS PAC ID: 2365600913 Enrollment ID: I20120228000595 |
Provider Name | David A Dominguez |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1689772469 PECOS PAC ID: 4880868702 Enrollment ID: I20121228000382 |
Provider Name | Nicholas Evangelidis |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1386965507 PECOS PAC ID: 0749592301 Enrollment ID: I20150710000050 |
Provider Name | Roy P Wilson |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1033309265 PECOS PAC ID: 9335459460 Enrollment ID: I20151102002202 |
Provider Name | Michelle L Boggs |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1750835070 PECOS PAC ID: 7113212374 Enrollment ID: I20160826000915 |
Provider Name | Candee Noelle Copeland |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1073173548 PECOS PAC ID: 9638590813 Enrollment ID: I20200526000411 |
Provider Name | Jenna Norton |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1225489388 PECOS PAC ID: 6406278498 Enrollment ID: I20200619002494 |
Provider Name | Angela Christine Kingsbury |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1427662865 PECOS PAC ID: 7517387798 Enrollment ID: I20201009001693 |
Provider Name | Mallory Garza |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1285270926 PECOS PAC ID: 5890115844 Enrollment ID: I20201014000400 |
Provider Name | Michael Garza |
---|---|
Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1275141434 PECOS PAC ID: 5294145496 Enrollment ID: I20201029000190 |
Provider Name | Susan E Marshall |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1366005357 PECOS PAC ID: 6103152848 Enrollment ID: I20201215001642 |
Provider Name | Carlos Vrijido Martinez |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1033388467 PECOS PAC ID: 5991114712 Enrollment ID: I20210507001334 |
Provider Name | Rachel Yvonne Kaufman |
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Provider Type | Practitioner - Psychologist Billing Independently |
Provider Identifiers | NPI Number: 1316353329 PECOS PAC ID: 4587073127 Enrollment ID: I20210511001686 |
Provider Name | Matthew C Wassom |
---|---|
Provider Type | Practitioner - Psychologist Billing Independently |
Provider Identifiers | NPI Number: 1588998702 PECOS PAC ID: 1153730700 Enrollment ID: I20210511001942 |
Provider Name | Susan Me'chelle Oliver |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1548874159 PECOS PAC ID: 8123427101 Enrollment ID: I20210524002535 |
Provider Name | Jessica Faith Hodges |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1316223225 PECOS PAC ID: 7719363019 Enrollment ID: I20221010000920 |
Provider Name | Caitlin Keptner |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1013255074 PECOS PAC ID: 1759678030 Enrollment ID: I20221117001771 |
Provider Name | Kirk Stoner |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1437844909 PECOS PAC ID: 6709230113 Enrollment ID: I20231003002260 |
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