College Hill OB/GYN, P.a.
Organization Active NPI Specialist · Wichita, KS
NPI 1083688980 · NPPES record last updated Oct 23, 2024
Key facts
- NPI
- 1083688980
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Specialist 174400000X
- Legal business name
- COLLEGE HILL OB/GYN, P.A.
- Practice address
- 3233 E 2ND St N
Wichita, KS 67208-3202 - Phone
- (316) 683-6766
- Fax
- (316) 616-0073
- NPI assigned
- Feb 15, 2006
- Organization subpart
- No
Authorized official
- Name
- Mignon Lynn Brewster, RN
- Title
- Practice Administrator
- Phone
- (316) 871-1148
Practitioners 10
-
Carla Burford, MD
-
Janna M Chibry, MD
-
Victoria M Fraizer, APRN
-
Ashley S Robbins, MD
-
Anna F Stork-Fury, D.O.
-
Laura Whisler, MD
-
Maggie Woods, MD
-
Karen R Strecker, MD
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 17D0927901 | College Hill OB/GYN | Certificate of waiver | Oct 26, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040907001199 | KS | Part B Supplier - Clinic/Group Practice | 0941276307 |
Receives reassigned benefits from 8 practitioners Practice locations: Wichita, KS |
National Provider Directory
Locations
3233 E 2nd St N
Wichita, KS 67208
Phone (316) 683-6766
834 N Socora St
Unit 200
Wichita, KS 67212
834 N Socora St
Lowr Lvl
Wichita, KS 67212
Phone (316) 773-3979
843 N Socora St Lowr Level
Wichita, KS 67212
Interoperability endpoints
- https://api.platform.athenahealth.com/11234/brand/1/csg/1/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist |
174400000X | KS | Yes |
Addresses
Primary practice location
3233 E 2ND St N
Wichita, KS 67208-3202
Mailing address
3233 E 2ND St N
Wichita, KS 67208-3202
Phone (316) 683-6766
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100392890A | Medicaid | KS | |
| 17D0927901 | Other | KS | CLIA ID # |
NPI Registry JSON
{
"created_epoch": "1139961600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1729641600000",
"number": "1083688980",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3233 E 2ND ST N",
"city": "WICHITA",
"state": "KS",
"postal_code": "672083202",
"telephone_number": "316-683-6766",
"fax_number": "316-616-0073"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3233 E 2ND ST N",
"city": "WICHITA",
"state": "KS",
"postal_code": "672083202",
"telephone_number": "316-683-6766",
"fax_number": "316-616-0073"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "COLLEGE HILL OB/GYN, P.A.",
"organizational_subpart": "NO",
"enumeration_date": "2006-02-15",
"last_updated": "2024-10-23",
"certification_date": "2024-10-23",
"status": "A",
"authorized_official_last_name": "BREWSTER",
"authorized_official_first_name": "MIGNON",
"authorized_official_middle_name": "LYNN",
"authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
"authorized_official_telephone_number": "316-871-1148",
"authorized_official_credential": "RN"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Specialist",
"state": "KS",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100392890A",
"state": "KS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CLIA ID #",
"identifier": "17D0927901",
"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. Record last updated by the provider on Oct 23, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.