| Main | |
|
527 N Grove St Wichita KS 67214-4520 | |
| (316) 262-2415 | |
| (316) 264-4734 |
| Full Name | Main |
|---|---|
| Speciality | Clinic/Center |
| Location | 527 N Grove St, Wichita, Kansas |
| Authorized Official Name and Position | Ronald Saal (CFO) |
| Authorized Official Contact | 3162622415 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Main 2318 E Central Ave Wichita KS 67214-4436 Ph: (316) 262-2415 | Main 527 N Grove St Wichita KS 67214-4520 Ph: (316) 262-2415 |
| NPI Number | 1376618348 |
|---|---|
| Provider Enumeration Date | 11/22/2006 |
| Last Update Date | 03/22/2021 |
| Medicare PECOS PAC ID | 5193632941 |
|---|---|
| Medicare Enrollment ID | O20040220001001 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376618348 | NPI | - | NPPES |
| 003947 | Other | KS | BCBS GROUP |
| 100212200B | Medicaid | KS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Kansas) | Primary |
| Provider Name | Thalia J Lopez |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1073518825 PECOS PAC ID: 5193620748 Enrollment ID: I20031205000310 |
| Provider Name | Dawne A Lowden |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1568414944 PECOS PAC ID: 9931175585 Enrollment ID: I20040907000203 |
| Provider Name | Harold L Perkins |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1427014430 PECOS PAC ID: 3971545385 Enrollment ID: I20050525001152 |
| Provider Name | Melissa J Hague |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1467462812 PECOS PAC ID: 2961408398 Enrollment ID: I20061009000120 |
| Provider Name | Zachary C Kuhlmann |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1174744734 PECOS PAC ID: 6608975362 Enrollment ID: I20070620000504 |
| Provider Name | Alan S Wiggins |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1831422831 PECOS PAC ID: 3274672407 Enrollment ID: I20091202000096 |
| Provider Name | Susan Steinfeldt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184973513 PECOS PAC ID: 5698925535 Enrollment ID: I20121030000383 |
| Provider Name | Lauretta J Moffitt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386953933 PECOS PAC ID: 8921223488 Enrollment ID: I20140626000365 |
| Provider Name | Virginia M Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871901140 PECOS PAC ID: 7214251404 Enrollment ID: I20150116001068 |
| Provider Name | Tai A Schmotzer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518359439 PECOS PAC ID: 1850603580 Enrollment ID: I20150708002508 |
| Provider Name | Conrado M Agustin |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1558454686 PECOS PAC ID: 8224336870 Enrollment ID: I20160414000795 |
| Provider Name | Michelle L Harris |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497983720 PECOS PAC ID: 4880978857 Enrollment ID: I20170313000890 |
| Provider Name | Caitlin Chiles |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629458666 PECOS PAC ID: 2365756475 Enrollment ID: I20180718000722 |
| Provider Name | Son T Nguyen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780064022 PECOS PAC ID: 9537472659 Enrollment ID: I20180924000537 |
| Provider Name | Elizabeth J Rempel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023521671 PECOS PAC ID: 9739423807 Enrollment ID: I20181129002571 |
| Provider Name | Holly E Montgomery |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1356723035 PECOS PAC ID: 5092029132 Enrollment ID: I20190624000288 |
| Provider Name | Ashley N Heimerman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629620117 PECOS PAC ID: 3577891373 Enrollment ID: I20190816002937 |
| Provider Name | Jane N Miriti |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033752407 PECOS PAC ID: 6305272378 Enrollment ID: I20200211001318 |
| Provider Name | Alan David Jones |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1669746624 PECOS PAC ID: 9739484775 Enrollment ID: I20200715002935 |
| Provider Name | Kamalakar Surineni |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1730619776 PECOS PAC ID: 9133490220 Enrollment ID: I20210607002187 |
| Provider Name | Kaitlin Boger |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053675025 PECOS PAC ID: 0547632218 Enrollment ID: I20230206001499 |
| Provider Name | Benjamen Benson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578903944 PECOS PAC ID: 8729451075 Enrollment ID: I20230307001634 |
Form Associates, P.a. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 801 E Douglas Ave Fl 2, Wichita, KS 67202 Phone: 617-505-1520 | |
Primary Care Associates, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 7111 E 21st St N Ste A, Wichita, KS 67206 Phone: 316-684-2851 | |
Substance Abuse At Hunter Health Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2318 E Central Ave, Wichita, KS 67214 Phone: 316-262-3611 Fax: 316-262-0741 | |
Freestate Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4723 E Douglas Ave, Wichita, KS 67218 Phone: 888-505-1776 Fax: 888-505-1776 | |
Centerwell Senior Primary Care (ks) Pa - Parklane Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 961 S Glendale St, Wichita, KS 67218 Phone: 316-618-9555 | |
Robert A Sweet Md Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3122 N Cypress Dr, Suite 100, Wichita, KS 67226 Phone: 316-260-4747 | |
World Impact, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3701 E 13th St N, #400, Wichita, KS 67208 Phone: 316-682-1880 |