Cindy Daugherty, MD
Individual provider Active NPI Pediatrics Physician · Wichita, KS
NPI 1003873449 · NPPES record last updated Jan 27, 2022
Key facts
- NPI
- 1003873449
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 0427431 (KS)
- Practice address
- 620 N Carriage Pkwy
Wichita, KS 67208-4501 - Phone
- (316) 962-3100
- Fax
- (316) 962-3132
- NPI assigned
- Apr 28, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20051101000599 | KS | Practitioner - Pediatric Medicine | 8527025287 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0427431 | KS | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wesley Physicians Medical Specialties LLC | Current |
Accepting new patients | |
| Kansas Physicians Group, LLC | Past | Accepting new patients |
Locations
2600 N Woodlawn Blvd
Wichita, KS 67220
Phone (316) 260-1690
620 N Carriage Pkwy
Wichita, KS 67208
Phone (316) 962-3100
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 0427431 | KS | Yes |
Addresses
Primary practice location
620 N Carriage Pkwy
Wichita, KS 67208-4501
Mailing address
620 N Carriage Pkwy
Wichita, KS 67208-4501
Phone (316) 962-3100
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100191190B | Medicaid | KS |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | CINDY.DAUGHERTY@hca3.eclinicaldirectplus.com |
Other providers in Wichita, KS
- Darrell J Youngman DO PA
- Sarah R Darrington
- Marvel A Darrough
- Bradley Robert Dart
- Lillian Nyawira Dasilva
- Hitanshu Dave
- David F Mendoza DMD
- David L Waldie Optometry
- David R. Koepsel D.D.S., LLC
- Gary Davidson
All providers in Wichita, KS · Pediatrics Physician in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 27, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.