KSP Health - Mo LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

KSP HEALTH - MO LLC

Practice address

117 S Lexington St Ste 100
Harrisonville, MO 64701-2444

Phone

(316) 516-2853

NPI assigned

Apr 10, 2024

Organization subpart

No

Name

Muthukumar Vellaichamy, MDNPI 1396778973

Title

Sole Member

Phone

(316) 516-2853

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Muthukumar Vellaichamy, M.D.

  • Pediatric Critical Care Medicine Physician
  • Topeka, KS
  • NPI 1396778973
  NPD (past) Authorized official
• Seth J Bremyer, LCPC

  • Professional Counselor
  • Wichita, KS
  • NPI 1144311523
  NPD (past)
• Shelby R Brooks, APRN

  • Nurse Practitioner
  • Topeka, KS
  • NPI 1912561739
  NPD (past)
• Michael Patrick Herriges, ARNP-C

  • Family Nurse Practitioner
  • Osawatomie, KS
  • NPI 1780686915
  NPD (past)
• Carey Jo Wettstein, NP-C

  • Primary Care Nurse Practitioner
  • Wichita, KS
  • NPI 1437501418
  NPD (past)
• Casey Jeanette Wettstein, NP-C

  • Family Nurse Practitioner
  • Wichita, KS
  • NPI 1962854604
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 10, 2024.

{
    "created_epoch": "1712707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712707200000",
    "number": "1124871074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6446 E CENTRAL AVE STE 183",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672061923",
            "telephone_number": "316-516-2853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 S LEXINGTON ST STE 100",
            "city": "HARRISONVILLE",
            "state": "MO",
            "postal_code": "647012444",
            "telephone_number": "316-516-2853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KSP HEALTH - MO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-10",
        "last_updated": "2024-04-10",
        "certification_date": "2024-04-10",
        "status": "A",
        "authorized_official_last_name": "VELLAICHAMY",
        "authorized_official_first_name": "MUTHUKUMAR",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "316-516-2853",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• King Manor Isl
• Kristi Marie Kittilstad, PLPC
• Adrienne Louise Klein, PT, DPT
• Lisa Klockenga, PLPC
• Karlyn Kobilnyk, LPC, MA
• Stacie Kubicsko, APRN
• Barbara E Kuchta, LPC
• Jackie D Kumm, F.N.P.
• Melinda Michelle Lacy, RN, FNP-BC
• Dianna Larman, PTA

• All providers in Harrisonville, MO
• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2024; 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.