Individual provider Active NPI

Lyle D Vierthaler, MD

  • Anesthesiology Physician
  • Wichita, KS
National Provider Identifier
1194727768
Registry record updated Jun 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
0410257 Issued in KS
Practice address
8080 E Central Ave
Ste 250
Wichita, KS 67206-2361
Phone
(316) 686-7327
Fax
(316) 686-1557
NPI assigned
Aug 12, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 0410257 KS Primary

Addresses

Primary practice location

8080 E Central Ave
Ste 250
Wichita, KS 67206-2361

Mailing address

8080 E Central Ave
Ste 250
Wichita, KS 67206-2361
Phone (316) 686-7327

Other identifiers 1

IdentifierTypeStateIssuer
100198220AMedicaidKS

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

LicenseStateTypeSpecialty
0410257KSMDAnesthesiology Physician

NPI Registry JSON

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

{
    "created_epoch": "1123804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402876800000",
    "number": "1194727768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8080 E CENTRAL AVE",
            "address_2": "STE 250",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672062361",
            "telephone_number": "316-686-7327",
            "fax_number": "316-686-1557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8080 E CENTRAL AVE",
            "address_2": "STE 250",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672062361",
            "telephone_number": "316-686-7327",
            "fax_number": "316-686-1557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIERTHALER",
        "first_name": "LYLE",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-12",
        "last_updated": "2014-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "KS",
            "license": "0410257",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100198220A",
            "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 Jun 16, 2014; 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.