Individual provider Active NPI

David Earl Petrie, MD

  • Anesthesiology Physician
  • Wichita, KS
National Provider Identifier
1265653992
Registry record updated Sep 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
0432621 Issued in KS
Practice address
929 N Saint Francis St
Wichita, KS 67214-3821
Phone
(800) 374-5326
Fax
(800) 374-7656
NPI assigned
May 1, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 6367 KS
Anesthesiology Physician 207L00000X 0432621 KS Primary

Addresses

Primary practice location

929 N Saint Francis St
Wichita, KS 67214-3821

Mailing address

PO Box 356
Wichita, KS 67201-0356
Phone (800) 374-5326

Other identifiers 2

IdentifierTypeStateIssuer
200608960AMedicaidKS
P00727381OtherKSRR MEDICARE GROUP# CQ2302

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090722000076 KS Practitioner - Anesthesiology 4880746809 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Kansas School of Med (KC/Wich/Sal), 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Consulting Services, PAGroup PAC ID 7214849710, 75 clinicians

Practice addresses (Care Compare)

14800 W Saint Teresa St
Wichita, KS 67235-9602

2770 N Webb Rd
Wichita, KS 67226-8112
Phone (316) 634-0090

929 N Saint Francis Ave
Wichita, KS 67214-3821
Phone (316) 268-5000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0432621KSMDAnesthesiology Physician
6367KSMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kansas Spine Anesthesia Corporation PA CurrentSince Sep 8, 2021 Accepting new patients
Anesthesia Consulting Services, PA Anesthesiology CurrentSince Jul 1, 2009 Accepting new patients

Locations

1708 E 23rd Ave
Hutchinson, KS 67502
Phone (620) 663-7187

3223 N Webb Rd
Ste 5
Wichita, KS 67226
Phone (316) 462-5000

4013 N Ridge Rd
Ste 100
Wichita, KS 67205
Phone (316) 722-8015

929 N Saint Francis Ave
Wichita, KS 67214
Phone (316) 291-4396

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Kansas Surgery and Recovery CenterWichita, KS, CCN 170183 Hospital Limited Partnership Interest (0.32%) Sep 7, 2021

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442880000000",
    "number": "1265653992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 356",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672010356",
            "telephone_number": "800-374-5326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "929 N SAINT FRANCIS ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672143821",
            "telephone_number": "800-374-5326",
            "fax_number": "800-374-7656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRIE",
        "first_name": "DAVID",
        "middle_name": "EARL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-01",
        "last_updated": "2015-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "KS",
            "license": "6367",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "KS",
            "license": "0432621",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200608960A",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE GROUP# CQ2302",
            "identifier": "P00727381",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.