John Vrtiska MD PA

Primary specialty

Gynecology PhysicianTaxonomy code 207VG0400X

License

T01174 Issued in KS

Legal business name

JOHN VRTISKA MD PA

Practice address

112 Ross Blvd
Suite a
Dodge City, KS 67801-7219

Phone

(620) 225-5496

Fax

(620) 225-5495

NPI assigned

Jun 1, 2007

Organization subpart

No

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

Authorized official

Name

Dr. John Norman Vrtiska, MD

Title

MD President

Phone

(620) 225-5496

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1180656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1265634315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 ROSS BLVD",
            "address_2": "SUITE A",
            "city": "DODGE CITY",
            "state": "KS",
            "postal_code": "678017219",
            "telephone_number": "620-225-5496",
            "fax_number": "620-225-5495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 ROSS BLVD",
            "address_2": "SUITE A",
            "city": "DODGE CITY",
            "state": "KS",
            "postal_code": "678017219",
            "telephone_number": "620-225-5496",
            "fax_number": "620-225-5495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN VRTISKA MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "VRTISKA",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "NORMAN",
        "authorized_official_title_or_position": "MD PRESIDENT",
        "authorized_official_telephone_number": "620-225-5496",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "KS",
            "license": "T01174",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.