Active NPI
Laurie Ebenkamp, RPT
- Physical Therapist
- Wichita, KS
National Provider Identifier
1033243795
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1101587
- Practice address
- 1 Cessna Blvd
Wichita, KS 67215-1400 - Phone
- (316) 517-7455
- NPI assigned
- Mar 15, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1101587 | KS | Primary |
Addresses
Primary practice location
1 Cessna Blvd
Wichita, KS 67215-1400
Mailing address
465 W 90TH Ave N
Conway Springs, KS 67031-8020
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KS
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1989
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
19931 W Kellogg Dr
Goddard, KS 67052-8864
Phone (316) 550-6132
223 N Main St
Cheney, KS 67025-9730
Phone (316) 550-6132
501 E Ross St
Harter Physical Therapy
Clearwater, KS 67026-7829
Phone (316) 550-6132
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1101587 | KS | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Via Christi Rehabilitation Hospital, Inc | Physical Therapist | Past | Accepting new patients |
| Ascension Via Christi Rehabilitation Hospital, Inc. | Past | Accepting new patients |
Interoperability endpoints
- https://api.platform.athenahealth.com/20807/brand/4/csg/1/fhir/r4
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Physical Therapist
- Goddard, KS
- NPI 1699195446
-
- Rehabilitation Hospital
- Wichita, KS
- NPI 1083604789
-
- Family Medicine Physician
- Wichita, KS
- NPI 1598001331
Physical Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173916800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1033243795",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "465 W 90TH AVE N",
"city": "CONWAY SPRINGS",
"state": "KS",
"postal_code": "670318020"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 CESSNA BLVD",
"city": "WICHITA",
"state": "KS",
"postal_code": "672151400",
"telephone_number": "316-517-7455"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EBENKAMP",
"first_name": "LAURIE",
"credential": "RPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "KS",
"license": "1101587",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Wichita, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.