Cardiovascular Anesthesia of Wichita, LLC
Organization Active NPI Anesthesiology Physician · Wichita, KS
NPI 1093048431 · NPPES record last updated Sep 17, 2009
Key facts
- NPI
- 1093048431
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Anesthesiology Physician 207L00000X
- Legal business name
- CARDIOVASCULAR ANESTHESIA OF WICHITA, LLC
- Practice address
- 3601 N Webb Rd
Wichita, KS 67226-8129 - Phone
- (316) 630-5000
- NPI assigned
- Sep 17, 2009
- Organization subpart
- No
Authorized official
- Name
- Tom Ashcom
- Title
- MD
- Phone
- (316) 685-6091
Member of 1
Practitioners 17
-
Shelley E Barger, CRNA
-
Amanda Leeann Douglass, CRNA
-
Zacharias Goudie, CRNA
-
Amy Maria Hittle, CRNA
-
Amy Michelle King, CRNA
-
Sinisa Malinovic, MD
-
Erica J Perez, CRNA
-
Tiffany C Steckley, CRNA
-
Thomas L Ashcom, M.D., PH.D.
-
Kelly D Holloway, MD
-
Jeremy M Salsbury, CRNA
-
Tracey Leann Stover, CRNA
-
Donna I Vierthaler, CRNA
-
Jaime Lou Whiteaker, CRNA
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100108000075 | KS | Part B Supplier - Clinic/Group Practice | 2567503808 |
Receives reassigned benefits from 9 practitioners Practice locations: Wichita, KS |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician |
207L00000X | Yes | ||
| Certified Registered Nurse Anesthetist |
367500000X |
Addresses
Primary practice location
3601 N Webb Rd
Wichita, KS 67226-8129
Mailing address
PO Box 1913
Wichita, KS 67201-1913
Phone (316) 685-6236
Other providers in Wichita, KS
- Seth L Carder
- Cardiac Cath Lab of Wichita LP
- Cardinal Hospice of Kansas LLC
- Cardio-Kidney Vascular Care LLC
- Cardio-Kidney Vascular Obl LLC
- Cardiovascular Care, P.a.
- Cardiovascular Consultants of Kansas, PA
- Cardiovascular Imaging Inc
- Care a Lot Counseling Services LLC
- Careatc
All providers in Wichita, KS · Anesthesiology Physician in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 17, 2009. 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.