Thi of Kansas at Wichita Specialty, LLC

Primary specialty

Long Term Care HospitalTaxonomy code 282E00000X

License

H087007 Issued in KS

Legal business name

THI OF KANSAS AT WICHITA SPECIALTY, LLC

Doing business as

Wichita Specialty Hospital

Practice address

8080 E Pawnee St
Wichita, KS 67207-5475

Phone

(316) 682-0004

NPI assigned

Jun 4, 2006

Organization subpart

No

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

Authorized official

Name

Bryan Roby

Title

President

Phone

(316) 682-0004

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Wichita Specialty Hospital Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Hospital certification: CCN 172003

Legal name

WICHITA-AMG SPECIALTY HOSPITAL

Certification status

Terminated Voluntary: merger or closure, Dec 15, 2017

Provider type (POS)

Hospital – Long-term

Participating since

Dec 1, 1993

Last certification

Jun 6, 2014

Beds

26

Ownership / control type

Private (for profit)

Most recent change of ownership

Aug 30, 2003 (3 total)

Facility address

8080 E Pawnee
Wichita, KS 67207

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

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208908800000",
    "number": "1245278605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 RIDGEBROOK RD",
            "city": "SPARKS",
            "state": "MD",
            "postal_code": "211529390",
            "telephone_number": "410-773-1000",
            "fax_number": "410-773-1321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8080 E PAWNEE ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672075475",
            "telephone_number": "316-682-0004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THI OF KANSAS AT WICHITA SPECIALTY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-04",
        "last_updated": "2008-04-23",
        "status": "A",
        "authorized_official_last_name": "ROBY",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "316-682-0004"
    },
    "taxonomies": [
        {
            "code": "282E00000X",
            "taxonomy_group": "",
            "desc": "Long Term Care Hospital",
            "state": "KS",
            "license": "H087007",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200539570A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wichita Specialty Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Long Term Care Hospital in Wichita, KS
• Providers in Wichita, KS by specialty
• Long Term Care Hospital in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.