Active NPI
Podiatry Clinic, P.a.
- Podiatrist
- Wichita, KS
National Provider Identifier
1043419625
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- 12-00142
- Legal business name
- PODIATRY CLINIC, P.A.
- Practice address
- 400 N Woodlawn St Ste 211
Wichita, KS 67208-4332 - Phone
- (316) 685-3801
- Fax
- (316) 685-6901
- NPI assigned
- Jul 13, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Larry K McNeil, D.P.M.
- Title
- President
- Phone
- (316) 685-3801
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | 12-00142 | KS | Primary |
Addresses
Primary practice location
400 N Woodlawn St Ste 211
Wichita, KS 67208-4332
Mailing address
400 N Woodlawn St Ste 211
Wichita, KS 67208-4332
Phone (316) 685-3801
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 480029429 | Other | KS | RRMEDICARE |
| 100094390B | Medicaid | KS |
National Provider Directory
National Provider DirectoryLocations
640 N Osage St
Augusta, KS 67010
Phone (316) 775-1189
400 N Woodlawn St
Ste 211
Wichita, KS 67208
Phone (316) 685-3801
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Foot & Ankle Surgery Podiatrist
- Hastings, NE
- NPI 1669112868
-
- Foot & Ankle Surgery Podiatrist
- Hastings, NE
- NPI 1386932564
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184284800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1386892800000",
"number": "1043419625",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 N WOODLAWN ST STE 211",
"city": "WICHITA",
"state": "KS",
"postal_code": "672084332",
"telephone_number": "316-685-3801",
"fax_number": "316-685-6901"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 N WOODLAWN ST STE 211",
"city": "WICHITA",
"state": "KS",
"postal_code": "672084332",
"telephone_number": "316-685-3801",
"fax_number": "316-685-6901"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PODIATRY CLINIC, P.A.",
"organizational_subpart": "NO",
"enumeration_date": "2007-07-13",
"last_updated": "2013-12-13",
"status": "A",
"authorized_official_last_name": "MCNEIL",
"authorized_official_first_name": "LARRY",
"authorized_official_middle_name": "K",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "316-685-3801",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "D.P.M."
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Podiatrist",
"state": "KS",
"license": "12-00142",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RRMEDICARE",
"identifier": "480029429",
"state": "KS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100094390B",
"state": "KS"
}
],
"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 Dec 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.