Vongsavanh Ted Phimsiprasom, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

112882 Issued in KS

Practice address

5500 E Kellogg Dr
Wichita, KS 67218-1607

Phone

(316) 803-2356

Fax

(316) 469-0815

NPI assigned

Jul 5, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1688515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688515200000",
    "number": "1053099630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11436 E PINE MEADOW CT",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672067202",
            "telephone_number": "316-992-7290",
            "fax_number": "316-469-0815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 E KELLOGG DR",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672181607",
            "telephone_number": "316-803-2356",
            "fax_number": "316-469-0815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHIMSIPRASOM",
        "first_name": "VONGSAVANH",
        "middle_name": "TED",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-07-05",
        "last_updated": "2023-07-05",
        "certification_date": "2023-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KS",
            "license": "112882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margaret Kathleen Phillips, ED. S., T-LMLP
• Matthew Phillips, PA-C
• Rachel S Phillips, PA
• Shaunita Phillips
• Paula S Philson, LSCSW
• Carla J Phipps, LAC
• Emmaly S Phipps, T-LMFT
• Grant E Phipps, D.D.S.
• Taylor Phipps, DDS
• Malaki Phiri

• Registered Nurse in Wichita, KS
• Providers in Wichita, KS by specialty
• Registered Nurse in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2023; 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.