Active NPI
Linus C Ohaebosim, DO
- Family Medicine Physician
- Wichita, KS
National Provider Identifier
1285792218
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 05-16911
- Practice address
- 2810 E 21St St
Wichita, KS 67214-2252 - Phone
- (316) 681-1901
- Fax
- (316) 681-1901
- NPI assigned
- Dec 4, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 05-16911 | KS | Primary |
Addresses
Primary practice location
2810 E 21St St
Wichita, KS 67214-2252
Mailing address
2810 E 21St St
Wichita, KS 67214-2252
Phone (316) 681-1901
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4083832 | Other | AETNA | |
| 693 | Other | KS | PHS |
| 100098690A | Medicaid | KS | |
| 49202 | Other | KS | BLUE SHIELD |
| 614790 | Other | FIRST GUARD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05-16911 | KS | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1277337600000",
"number": "1285792218",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2810 E 21ST ST",
"city": "WICHITA",
"state": "KS",
"postal_code": "672142252",
"telephone_number": "316-681-1901",
"fax_number": "316-618-7362"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2810 E 21ST ST",
"city": "WICHITA",
"state": "KS",
"postal_code": "672142252",
"telephone_number": "316-681-1901",
"fax_number": "316-681-1901"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OHAEBOSIM",
"first_name": "LINUS",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-04",
"last_updated": "2010-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "KS",
"license": "05-16911",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4083832",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHS",
"identifier": "693",
"state": "KS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100098690A",
"state": "KS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "49202",
"state": "KS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST GUARD",
"identifier": "614790",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Wichita, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.