| M-care Healthcare Llc | |
|
731 N Mclean Blvd Ste 100 Wichita KS 67203-4935 | |
| (316) 461-0339 | |
| (316) 221-1000 |
| Full Name | M-care Healthcare Llc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 731 N Mclean Blvd Ste 100, Wichita, Kansas |
| Authorized Official Name and Position | Vincent O Mogoi (SOLE OWNER) |
| Authorized Official Contact | 3165191543 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| M-care Healthcare Llc 731 N Mclean Blvd Ste 100 Wichita KS 67203-4935 Ph: (316) 461-0339 | M-care Healthcare Llc 731 N Mclean Blvd Ste 100 Wichita KS 67203-4935 Ph: (316) 461-0339 |
| NPI Number | 1013421353 |
|---|---|
| Provider Enumeration Date | 11/22/2017 |
| Last Update Date | 07/11/2024 |
| Certification Date | 07/11/2024 |
| Medicare PECOS PAC ID | 4880958974 |
|---|---|
| Medicare Enrollment ID | O20180425000979 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013421353 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Primary |
| Provider Name | Stephen G Grillot |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1083714380 PECOS PAC ID: 6002850716 Enrollment ID: I20050614000641 |
| Provider Name | Sheila Marie Ebersole |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235148305 PECOS PAC ID: 9234222555 Enrollment ID: I20070912000335 |
| Provider Name | Kathryn D Thiessen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497720981 PECOS PAC ID: 9436225877 Enrollment ID: I20080908000571 |
| Provider Name | Emily R Runyan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285894709 PECOS PAC ID: 9335287036 Enrollment ID: I20091118000302 |
| Provider Name | Amanda L Mogoi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801332564 PECOS PAC ID: 0244514081 Enrollment ID: I20170223000643 |
| Provider Name | Vincent O Mogoi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386181832 PECOS PAC ID: 5294010070 Enrollment ID: I20170317000112 |
| Provider Name | Tiffany Moos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427783380 PECOS PAC ID: 1759750060 Enrollment ID: I20221208001454 |
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