Wichita Primary Care LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

WICHITA PRIMARY CARE LLC

Practice address

2230 N Ridge Rd
Wichita, KS 67205-1053

Phone

(316) 448-8339

Fax

(316) 221-7149

NPI assigned

Jul 11, 2018

Organization subpart

No

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

Authorized official

Name

Heidi Larison, MDNPI 1447455662

Title

Owner

Phone

(316) 448-8339

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in KS

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 19

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

• Heidi D. Larison, DO

  • Family Medicine Physician
  • Wichita, KS
  • NPI 1447455662
  Medicare reassignment Care Compare group NPD Authorized official
• Miranda Bradfield, NP

  • Family Nurse Practitioner
  • Wichita, KS
  • NPI 1902545809
  Medicare reassignment Care Compare group NPD
• Suzanne Fisher

  • Nurse Practitioner
  • Wichita, KS
  • NPI 1790636462

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Brian Joseph Kowal, DPT, PT

  • Physical Therapist
  • Wichita, KS
  • NPI 1194380477
  Medicare reassignment Care Compare group NPD
• Shelby Nicole Lopez

  • Nurse Practitioner
  • Wichita, KS
  • NPI 1487339024
  Medicare reassignment Care Compare group NPD
• Brandy May Voegeli, APRN

  • Family Nurse Practitioner
  • Wichita, KS
  • NPI 1023855343
  Medicare reassignment Care Compare group NPD
• Sylvia Woodard

  • Family Nurse Practitioner
  • Wichita, KS
  • NPI 1063898823
  Medicare reassignment Care Compare group NPD
• Diemkieu Pham

  • Physician Assistant
  • Wichita, KS
  • NPI 1780259192
  Medicare reassignment Care Compare group
• Amy Lou Quinn, MPH, PA

  • Physician Assistant
  • Wichita, KS
  • NPI 1598221335
  Medicare reassignment Care Compare group
• Molly Bradley, LMSW

  • Clinical Social Worker
  • Augusta, KS
  • NPI 1417359373
  Medicare reassignment NPD
• Shana Cables, MS, RD, LD

  • Registered Dietitian
  • Andover, KS
  • NPI 1013564020
  Medicare reassignment NPD
• Rachel Nicole Davis

  • Registered Dietitian
  • Wichita, KS
  • NPI 1376433987
  Medicare reassignment NPD

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

{
    "created_epoch": "1531267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611532800000",
    "number": "1164908281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2230 N RIDGE RD",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672051053",
            "telephone_number": "316-448-8339",
            "fax_number": "316-221-7149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2230 N RIDGE RD",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672051053",
            "telephone_number": "316-448-8339",
            "fax_number": "316-221-7149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WICHITA PRIMARY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-11",
        "last_updated": "2021-01-25",
        "certification_date": "2021-01-25",
        "status": "A",
        "authorized_official_last_name": "LARISON",
        "authorized_official_first_name": "HEIDI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "316-448-8339",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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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 Jan 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.