Prairie Sage Functional Medicine and Kinesiology LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

0105657 Issued in KS

Legal business name

PRAIRIE SAGE FUNCTIONAL MEDICINE AND KINESIOLOGY LLC

Practice address

519 W Mary St Ste 115
Garden City, KS 67846-2782

Phone

(620) 276-8743

NPI assigned

Sep 30, 2016

Last updated

Sep 30, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. George Stanton Jr., D.C.NPI 1497159404

Title

Owner/Doctor

Phone

(620) 276-8743

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KS

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• George Stanton Jr., DC

  • Chiropractor
  • Garden City, KS
  • NPI 1497159404
  Medicare reassignment Care Compare group NPD Authorized official
• Michelle Stanton, D.C.

  • Chiropractor
  • Garden City, KS
  • NPI 1760928394
  Medicare reassignment Care Compare group NPD
• Raymond Eugene Walker Jr., DC

  • Chiropractor
  • Garden City, KS
  • NPI 1497708036
  NPD (past)
• Vincent Ombongi Mogoi, APRN

  • Nurse Practitioner
  • Greenwood Village, CO
  • NPI 1386181832
  NPD (past)

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

{
    "created_epoch": "1475193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475193600000",
    "number": "1265981385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "519 W MARY ST STE 115",
            "city": "GARDEN CITY",
            "state": "KS",
            "postal_code": "678462782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "519 W MARY ST STE 115",
            "city": "GARDEN CITY",
            "state": "KS",
            "postal_code": "678462782",
            "telephone_number": "620-276-8743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRAIRIE SAGE FUNCTIONAL MEDICINE AND KINESIOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-30",
        "last_updated": "2016-09-30",
        "status": "A",
        "authorized_official_last_name": "STANTON",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "OWNER/DOCTOR",
        "authorized_official_telephone_number": "620-276-8743",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KS",
            "license": "0105657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Aimee Porterfield
• Prairieview Home Health, L.L.C.
• Prohealth Chiropractic Wellness Centers, PA
• Prohealth Chiropractic Wellness Centers, PA
• Providence Professional Services, Inc.
• Providence Professional Services, LLC

• Chiropractor in Garden City, KS
• Providers in Garden City, KS by specialty
• Chiropractor in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.