NPIMap

Organization Active NPI

My Sacred Home II, LLC

  • Specialist
  • Wichita, KS
National Provider Identifier
1144457557
Registry record updated Jun 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
MY SACRED HOME II, LLC
Practice address
7829 E Rockhill St Ste 406
Wichita, KS 67206-3915
Phone
(316) 440-4820
Fax
(316) 440-4851
NPI assigned
Jun 12, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2009

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

Authorized official

Name
Jessica Manzano, MD
Title
Billing and Coding Manager
Phone
(316) 440-4820

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

7829 E Rockhill St Ste 406
Wichita, KS 67206-3915

Mailing address

7829 E Rockhill St Ste 406
Wichita, KS 67206-3915
Phone (316) 440-4820

National Provider Directory

National Provider Directory
Tax ID family
MSH Sleep Lab2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1244764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1244764800000",
    "number": "1144457557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7829 E ROCKHILL ST STE 406",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672063915",
            "telephone_number": "316-440-4820",
            "fax_number": "316-440-4851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7829 E ROCKHILL ST STE 406",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672063915",
            "telephone_number": "316-440-4820",
            "fax_number": "316-440-4851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY SACRED HOME II, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-12",
        "last_updated": "2009-06-12",
        "status": "A",
        "authorized_official_last_name": "MANZANO",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "BILLING AND CODING MANAGER",
        "authorized_official_telephone_number": "316-440-4820",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jun 12, 2009; 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.