Advanced Pain Medicine Associates, LLC
Organization Active NPI Specialist · Wichita, KS
NPI 1083982037 · NPPES record last updated Nov 11, 2022
Key facts
- NPI
- 1083982037
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Specialist 174400000X
- Legal business name
- ADVANCED PAIN MEDICINE ASSOCIATES, LLC
- Practice address
- 3715 N Oliver
Wichita, KS 67220-3404 - Phone
- (316) 942-4519
- Fax
- (316) 942-4655
- NPI assigned
- Dec 6, 2011
- Organization subpart
- No
Authorized official
- Name
- Dr. Jon C Parks, M.D
- Title
- President
- Phone
- (316) 942-4519
Practitioners 17
-
Amanda Barrett, APRN
-
Alexandra Michele Martin, APRN
-
Lindsey Rae McCall, ARNP
-
Kristin Zenner, FNP-C
-
Kristen M Babin, APRN
-
Amanda A Ewertz, ARNP
-
Derek W Fowler, APRN
-
Megan Theresa Poell, APRN
-
Amanda Peeples, PA
-
Aurora Cheyenne Yontz, APRN
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20111205000803 | KS | Part B Supplier - Clinic/Group Practice | 7113192063 |
Receives reassigned benefits from 16 practitioners Practice locations: Wichita, KS |
National Provider Directory
Locations
3715 N Oliver St
Wichita, KS 67220
Phone (316) 440-1276
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist |
174400000X | Yes | ||
| Pain Clinic/Center | 261QP3300X | |||
| Physiological Laboratory | 293D00000X | KS |
Addresses
Primary practice location
3715 N Oliver
Wichita, KS 67220-3404
Mailing address
3715 N Oliver
Wichita, KS 67220-3404
Phone (316) 942-4519
Other providers in Wichita, KS
- Advanced Medical DME, LLC
- Advanced Mens Health, LLC
- Advanced Mobile Healthcare, LLC
- Advanced Orthopaedic Associates, P.a.
- Advanced Orthopaedic Associates, PA
- Advanced Physical Therapy PA
- Advanced Podiatry, P.a.
- Advanced Practice Family Care LLC
- Advanced Practice Professionals, LLC
- Advanced PT 47TH Street LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 11, 2022. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.