Active NPI
Charles D Pence, MD
- Orthopaedic Surgery of the Spine Physician
- Wichita, KS
National Provider Identifier
1114954740
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery of the Spine Physician
- License
- 14229
- Practice address
- 1947 Founders St
Wichita, KS 67206-3548 - Phone
- (316) 689-9175
- Fax
- (316) 613-4704
- NPI assigned
- Jun 27, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery of the Spine Physician | 207XS0117X | 14229 | KS | Primary |
Addresses
Primary practice location
1947 Founders St
Wichita, KS 67206-3548
Mailing address
PO Box 8035
Wichita, KS 67208-0035
Phone (316) 689-9135
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 12149391 | Other | KS | MULTIPLAN |
| 001521 | Other | KS | BCBS |
| 722 | Other | KS | PHS |
| 200142 | Other | KS | HPK |
| 16915 | Other | KS | COVENTRY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14229 | KS | MD | Orthopaedic Surgery of the Spine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151366400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184284800000",
"number": "1114954740",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 8035",
"city": "WICHITA",
"state": "KS",
"postal_code": "672080035",
"telephone_number": "316-689-9135",
"fax_number": "316-689-9102"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1947 FOUNDERS ST",
"city": "WICHITA",
"state": "KS",
"postal_code": "672063548",
"telephone_number": "316-689-9175",
"fax_number": "316-613-4704"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENCE",
"first_name": "CHARLES",
"middle_name": "D",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-27",
"last_updated": "2007-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "207XS0117X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
"state": "KS",
"license": "14229",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MULTIPLAN",
"identifier": "12149391",
"state": "KS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "001521",
"state": "KS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHS",
"identifier": "722",
"state": "KS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HPK",
"identifier": "200142",
"state": "KS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COVENTRY",
"identifier": "16915",
"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. Last updated by the provider on Jul 13, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.