NPIMap

Organization Active NPI

Holy Family Medical Inc

  • Federally Qualified Health Center (FQHC)
  • Wichita, KS
National Provider Identifier
1215593249
Registry record updated Jun 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
HOLY FAMILY MEDICAL INC
Practice address
144 S Hillside St
Wichita, KS 67211-2154
Phone
(316) 682-9900
Fax
(316) 682-0311
NPI assigned
May 15, 2019
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Brenda Thanel
Title
Ceo
Phone
(316) 682-9900

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners 9

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS2 enrollments

Federally qualified health center certification: CCN 171900

Medicare enrollment files
Legal name
HOLY FAMILY MEDICAL INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jun 3, 2021
Last certification
Jun 3, 2021
Ownership / control type
For profit – corporation
Organization structure
OtherNon-profit
Incorporated
Feb 28, 2019 in KS
Enrollment address
144 S Hillside St
Wichita, KS 67211-2154

All disclosed owners & managing parties 3

Medicare enrollment files

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Holy Family Medical Inc Organization, Wichita, KS Medical provider/supplier, Non-profit Operational/Managerial Control Feb 28, 2019
Brenda Thanel Individual Corporate OfficerCeo Feb 28, 2019
W-2 Managing EmployeeCeo Feb 28, 2019
Ronald C Ferris Individual W-2 Managing EmployeeCmo Feb 28, 2019

Medicare enrollment records 2

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20190808002052 KS Part B Supplier - Clinic/Group Practice 1658608906 Receives reassigned benefits from 7 practitioners
Practice locations: Wichita, KS
O20210603002139 KS Part a Provider - Federally Qualified Health Center (FQHC) 1658608906 Practice locations: Wichita, KS

National Provider Directory

National Provider Directory

Locations

144 S Hillside St
Ste A
Wichita, KS 67211

1457 N Chautauqua Ave
Ste B
Wichita, KS 67214
Phone (316) 682-9900

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HOLYFM

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

NPPES NPI Registry

Primary practice location

144 S Hillside St
Wichita, KS 67211-2154

Mailing address

144 S Hillside St
Wichita, KS 67211-2154
Phone (316) 682-9900

Electronic endpoints 1

NPPES NPI Registry
TypeEndpointUseAffiliation
Direct Messaging Address admin@holyfamilymedical.e-mdsdirect.com Direct

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 10, 2021.

{
    "created_epoch": "1557878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623283200000",
    "number": "1215593249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "144 S HILLSIDE ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672112154",
            "telephone_number": "316-682-9900",
            "fax_number": "316-682-0311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "144 S HILLSIDE ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672112154",
            "telephone_number": "316-682-9900",
            "fax_number": "316-682-0311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLY FAMILY MEDICAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-15",
        "last_updated": "2021-06-10",
        "certification_date": "2021-06-10",
        "status": "A",
        "authorized_official_last_name": "THANEL",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "316-682-9900"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "admin@holyfamilymedical.e-mdsdirect.com",
            "affiliation": "N",
            "endpointDescription": "EMR",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "144 S Hillside St",
            "city": "Wichita",
            "state": "KS",
            "country_code": "US",
            "postal_code": "672112154",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.