NPIMap

Individual provider Active NPI

Gregory F Lakin, D.O., J.D.

  • Family Medicine Physician
  • Wichita, KS
National Provider Identifier
1003867953
Registry record updated Sep 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0528419 Issued in KS
Practice address
933 N Topeka St
Wichita, KS 67214-3620
Phone
(316) 201-1234
NPI assigned
May 15, 2006
Last updated
Sep 3, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0528419 KS Primary

Addresses

Primary practice location

933 N Topeka St
Wichita, KS 67214-3620

Mailing address

933 N Topeka St
Wichita, KS 67214-3620
Phone (316) 201-1234

Other practice location 1

1333 N Broadway Ave Ste A
Wichita, KS 67214-2894
Phone (316) 201-1234

Other identifiers 2

IdentifierTypeStateIssuer
103296OtherKSBCBS
100372970EMedicaidKS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031205000516 KS Practitioner - Family Practice 5799699658 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Juris Doctor

State licenses

LicenseStateTypeSpecialty
0528419KSMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
BHG XXX, LLC CurrentSince Aug 23, 2022 Accepting new patients
Center for Change LLC PastSince Jun 11, 2008 Accepting new patients
Emergency Services of Kansas, PA Family Medicine Past Accepting new patients
Center for Change - Lawrence LLC PastSince Aug 9, 2011 Accepting new patients

Locations

1125 N 5th St
Kansas City, KS 66101
Phone (913) 342-0888

5001 Spring Vly
Ste 600E
Dallas, TX 75244

Ownership & related parties

All facility ownership & control disclosures 5

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Lakepoint Retirement & Rehab Center of WichitaWichita, KS, CCN 175466 Skilled nursing facility Corporate Director (16.67%)
Operational/Managerial Control (16.67%)		 Mar 1, 2024
Mar 1, 2024
Family Health & Rehabilitation CenterWichita, KS, CCN 175501 Skilled nursing facility 5% Or Greater Indirect Ownership Interest (10.97%) Sep 1, 2020
Derby Health & Rehabilitation LLCDerby, KS, CCN 175514 Skilled nursing facility 5% Or Greater Indirect Ownership Interest (10.97%) Sep 1, 2020
Avita Health and Rehabilitation at Reeds CoveWichita, KS, CCN 175532 Skilled nursing facility 5% Or Greater Indirect Ownership Interest (10.97%) Sep 1, 2020
Nottingham Health and RehabilitationOlathe, KS, CCN 175540 Skilled nursing facility 5% Or Greater Indirect Ownership Interest (10.97%) Sep 1, 2020

Owned or controlled facilities with NPI records 5

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599091200000",
    "number": "1003867953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "933 N TOPEKA ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672143620",
            "telephone_number": "316-201-1234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "933 N TOPEKA ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672143620",
            "telephone_number": "316-201-1234"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1333 N Broadway Ave Ste A",
            "address_purpose": "LOCATION",
            "city": "Wichita",
            "state": "KS",
            "postal_code": "672142894",
            "country_code": "US",
            "telephone_number": "316-201-1234",
            "fax_number": "316-201-1673",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAKIN",
        "first_name": "GREGORY",
        "middle_name": "F",
        "credential": "D.O., J.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-15",
        "last_updated": "2020-09-03",
        "certification_date": "2020-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "0528419",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "103296",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100372970E",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.