Advanced Mens Health, LLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

0435145 Issued in KS

Legal business name

ADVANCED MENS HEALTH, LLC

Practice address

3460 N Ridge Road #90
Wichita, KS 67205-1222

Phone

(316) 689-9185

Fax

(316) 616-2095

NPI assigned

Mar 14, 2016

Last updated

Mar 14, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Clay E Lyddane, MD, PHDNPI 1760641476

Title

Owner

Phone

(316) 722-4725

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Clay Earl Lyddane, MD PHD

  • Urology Physician
  • Wichita, KS
  • NPI 1760641476
  Authorized official Same address or phone
• Stephanie Kay Marion, ARNP

  • Family Nurse Practitioner
  • Wichita, KS
  • NPI 1164739843
  NPD (past)

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

{
    "created_epoch": "1457913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457913600000",
    "number": "1063873354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "241 N HILLSIDE",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672146627",
            "telephone_number": "316-776-9495",
            "fax_number": "316-616-2095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3460 N RIDGE ROAD #90",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672051222",
            "telephone_number": "316-689-9185",
            "fax_number": "316-616-2095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED MENS HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-14",
        "last_updated": "2016-03-14",
        "status": "A",
        "authorized_official_last_name": "LYDDANE",
        "authorized_official_first_name": "CLAY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "316-722-4725",
        "authorized_official_credential": "MD, PHD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "KS",
            "license": "0435145",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200740730A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Advanced Orthopaedic Associates, PA
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• Specialist in Wichita, KS
• Providers in Wichita, KS by specialty
• Specialist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2016; 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.