Dedicated Physicians Group of Kansas LLC

Primary specialty

Non-Pharmacy Dispensing SiteTaxonomy code 332900000X

Legal business name

DEDICATED PHYSICIANS GROUP OF KANSAS LLC

Doing business as

Dedicated Senior Medical Center Grove

Practice address

2402 E 13TH St N
Wichita, KS 67214-2102

Phone

(316) 867-6444

Fax

(316) 867-6443

NPI assigned

Apr 15, 2022

Last updated

Oct 5, 2022By the provider in NPPES

Organization subpart

Yes

Parent organization

DEDICATED PHYSICIANS GROUP OF KANSAS LLCAs reported in NPPES

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

Authorized official

Name

Mary Chen

Title

Authorized Official

Phone

(305) 628-6117

Specialties & licenses 1

Addresses

Other names 1

• DEDICATED SENIOR MEDICAL CENTER GROVE Doing business as

Tax ID family

Dedicated Physicians Group of Kansas LLC2 organizations share this tax ID, including this one

Part of

Dedicated Physicians Group of Kansas LLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Dedicated Physicians Group of Kansas LLC

  dba Dedicated Senior Medical Center Glendale

  • Non-Pharmacy Dispensing Site
  • Wichita, KS
  • NPI 1558141747
  NPD tax ID

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

{
    "created_epoch": "1649980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664928000000",
    "number": "1023751328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1395 NW 167TH ST",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "331695710",
            "telephone_number": "305-628-6117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2402 E 13TH ST N",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672142102",
            "telephone_number": "316-867-6444",
            "fax_number": "316-867-6443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEDICATED PHYSICIANS GROUP OF KANSAS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DEDICATED PHYSICIANS GROUP OF KANSAS LLC",
        "enumeration_date": "2022-04-15",
        "last_updated": "2022-10-05",
        "certification_date": "2022-10-05",
        "status": "A",
        "authorized_official_last_name": "CHEN",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "305-628-6117"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DEDICATED SENIOR MEDICAL CENTER GROVE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Decide Your Legacy, LLC
• Howard Christopher Deck, P.T.
• Melissa Deckard, RN
• Andrew Declerk, MD
• Kielan Decou
• Dedicated Physicians Group of Kansas LLC (Dedicated Senior Medical Center Glendale)
• Dee's Counseling LLC
• Deena Sandall, OD., LLC
• Tiffany Defebaugh, COTA
• Heather Ann Deforeest, RPT

• Non-Pharmacy Dispensing Site in Wichita, KS
• Providers in Wichita, KS by specialty
• Non-Pharmacy Dispensing Site in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.