Wichita Pain Associates PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

0424741 Issued in KS

Legal business name

WICHITA PAIN ASSOCIATES PA

Doing business as

Wichita Pain Associates Cosmetic

Practice address

2548 N Maize CT
Suite 104
Wichita, KS 67205-7347

Phone

(316) 722-4247

Fax

(316) 722-4287

NPI assigned

Nov 18, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Jeffrey Duane Fenn, D.C.

Title

President

Phone

(316) 258-5955

Specialties & licenses 4

Addresses

Other names 1

• Wichita Pain Associates Cosmetic Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Steven Henson, MD

  • Emergency Medicine Physician
  • Wichita, KS
  • NPI 1518923580
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1321574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1356652800000",
    "number": "1134496193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2544 N MAIZE CT",
            "address_2": "SUITE 100",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672057324",
            "telephone_number": "316-722-4247",
            "fax_number": "316-722-4287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2548 N MAIZE CT",
            "address_2": "SUITE 104",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672057347",
            "telephone_number": "316-722-4247",
            "fax_number": "316-722-4287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WICHITA PAIN ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-18",
        "last_updated": "2012-12-28",
        "status": "A",
        "authorized_official_last_name": "FENN",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "DUANE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "316-258-5955",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": "KS",
            "license": "04-23263",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "0424741",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "0430440",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "KS",
            "license": "44143",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wichita Pain Associates Cosmetic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Family Medicine Physician in Wichita, KS
• Providers in Wichita, KS by specialty
• Family Medicine Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2012; 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.