Individual provider Active NPI

Laurie A. Gwyn, M.D.

  • Pediatrics Physician
  • Wichita, KS
National Provider Identifier
1043459407
Registry record updated Feb 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
0428303 Issued in KS
Practice address
550 N Hillside St
Wichita, KS 67214-4910
Phone
(316) 962-3150
Fax
(316) 962-7334
NPI assigned
Feb 9, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 0428303 KS Primary

Addresses

Primary practice location

550 N Hillside St
Wichita, KS 67214-4910

Mailing address

PO Box 47490
Wichita, KS 67201-7490
Phone (316) 962-3150

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090325000264 KS Practitioner - Pediatric Medicine 9032276746 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0428303KSMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Kansas School of Medicine Wichita Medical Practice Assoc Pediatrics CurrentSince Mar 15, 2018 Accepting new patients
Wesley Pathology Consultants PA Current Accepting new patients
Wesley Medical Center LLC Past Accepting new patients
Wesley Medical Center LLC Pediatrics Past Accepting new patients

Locations

1010 N Kansas St
Ste 3054
Wichita, KS 67214
Phone (316) 293-2647

3243 E Murdock St
Ste Lvl-G
Wichita, KS 67208
Phone (316) 962-3100

3243 E Murdock St
Ste Lvl-A
Wichita, KS 67208
Phone (316) 688-3150

1010 N Kansas St
Wichita, KS 67214
Phone (316) 293-2622

550 N Hillside St
Wichita, KS 67214
Phone (316) 688-2239

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AJHFCA

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1234137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328227200000",
    "number": "1043459407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 47490",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672017490",
            "telephone_number": "316-962-3150",
            "fax_number": "316-962-7334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 N HILLSIDE ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672144910",
            "telephone_number": "316-962-3150",
            "fax_number": "316-962-7334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GWYN",
        "first_name": "LAURIE",
        "middle_name": "A.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-09",
        "last_updated": "2012-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KS",
            "license": "0428303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.