| Restoration Health Care Llc | |
|
1541 N Lindberg Cir Wichita KS 67206-6400 | |
| (316) 258-5882 | |
| Not Available |
| Full Name | Restoration Health Care Llc |
|---|---|
| Speciality | Skilled Nursing Facility |
| Location | 1541 N Lindberg Cir, Wichita, Kansas |
| Authorized Official Name and Position | Jessica Manzano (DIRECTOR OF REVENUE CYCLE) |
| Authorized Official Contact | 3163127780 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Restoration Health Care Llc 12300 E Four Oaks St Wichita KS 67226-8366 Ph: () - | Restoration Health Care Llc 1541 N Lindberg Cir Wichita KS 67206-6400 Ph: (316) 258-5882 |
| NPI Number | 1184109803 |
|---|---|
| Provider Enumeration Date | 09/27/2018 |
| Last Update Date | 02/16/2021 |
| Medicare PECOS PAC ID | 2567708142 |
|---|---|
| Medicare Enrollment ID | O20190118001615 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184109803 | NPI | - | NPPES |
| 201281390A | Medicaid | KS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 314000000X | Skilled Nursing Facility | (* (Not Available)) | Primary |
| Provider Name | Reinaldo Ernesto Mijares |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1750490694 PECOS PAC ID: 8527002245 Enrollment ID: I20050614000764 |
| Provider Name | John J Womack |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1053357541 PECOS PAC ID: 4587678800 Enrollment ID: I20060126000170 |
| Provider Name | Kathrine L Manning |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124054572 PECOS PAC ID: 0244245488 Enrollment ID: I20060209000444 |
| Provider Name | Eleanor G Millsap |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356379978 PECOS PAC ID: 5193728707 Enrollment ID: I20060822000291 |
| Provider Name | Valerie D Koch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598920167 PECOS PAC ID: 6305978909 Enrollment ID: I20100716000785 |
| Provider Name | Lisa M Farrell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871872804 PECOS PAC ID: 6800069303 Enrollment ID: I20111028000109 |
| Provider Name | Tonya J Kasselman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720367626 PECOS PAC ID: 9032382494 Enrollment ID: I20111031000196 |
| Provider Name | Kathleen M Winslow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609190123 PECOS PAC ID: 0547406795 Enrollment ID: I20130415000232 |
| Provider Name | Jennifer Jean Frerichs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154706430 PECOS PAC ID: 7315260981 Enrollment ID: I20150826002553 |
| Provider Name | Nichole L Fischer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629552484 PECOS PAC ID: 9133473572 Enrollment ID: I20181121000750 |
| Provider Name | Jessica Mies |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386219921 PECOS PAC ID: 9931597002 Enrollment ID: I20211021001840 |
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