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Individual provider Active NPI

Emily Duethman, DO

  • Internal Medicine Physician
  • Wichita, KS
National Provider Identifier
1295096162
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0538283 Issued in KS
Practice address
929 N Saint Francis St
Wichita, KS 67214-3821
Phone
(316) 268-5000
NPI assigned
Jun 6, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 9407808 KS
Internal Medicine Physician 207R00000X 0538283 KS Primary

Addresses

Primary practice location

929 N Saint Francis St
Wichita, KS 67214-3821

Mailing address

929 N St Francis
Wichita, KS 67214
Phone (316) 268-5000

Other practice location 1

1010 N. Kansas
Wcgme
Wichita, KS 67214
Phone (316) 268-5000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171214000839 CO Practitioner - Internal Medicine 5395994818 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Kansas School of Med (KC/Wich/Sal), 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Intermountain Medical Group Grand Junction, LLCGroup PAC ID 3779707856, 297 clinicians

Practice addresses (Care Compare)

1050 Wellington Ave
Imh Wellington Lung and Sleep Clinic
Grand Junction, CO 81501-8121
Phone (970) 298-5864

2635 N 7TH St
Grand Junction, CO 81501-8209

Hospital & facility affiliations

  • Intermountain Health St. Mary'S Regional Hospital Hospital, Grand Junction, CO, CCN 060023
  • Community Hospital Hospital, Grand Junction, CO, CCN 060054
  • Family Health West Hospital Hospital, Fruita, CO, CCN 061302

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0538283KSMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Mary'S Hospital and Medical Center, Inc CurrentSince Nov 11, 2017 Accepting new patients
Intermountain Medical Group Grand Junction, LLC Internal Medicine CurrentSince Nov 1, 2020 Accepting new patients
St Mary'S Hospital and Medical Center, Inc Internal Medicine Current Accepting new patients
Intermountain Medical Group Grand Junction, LLC CurrentSince Nov 1, 2020 Accepting new patients
St Mary'S Hospital and Medical Center, Inc CurrentSince Nov 11, 2017 Accepting new patients
St. Mary'S Hospital and Medical Center, Inc. Past Accepting new patients

Locations

1050 Wellington Ave
Grand Junction, CO 81501
Phone (970) 245-4810

1050 Wellington Ave
Slp Ctr
Grand Junction, CO 81501
Phone (970) 298-5864

2635 N 7th St
Grand Junction, CO 81501
Phone (970) 244-2009

Organizations & group practices 6

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

Hospital & facility affiliations 6

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": "1338940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1295096162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "929 N ST FRANCIS",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "67214",
            "telephone_number": "316-268-5000"
        },
        {
            "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": "316-268-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1010 N. Kansas",
            "address_2": "WCGME",
            "address_purpose": "LOCATION",
            "city": "Wichita",
            "state": "KS",
            "postal_code": "67214",
            "country_code": "US",
            "telephone_number": "316-268-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUETHMAN",
        "first_name": "EMILY",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-06",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KS",
            "license": "9407808",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KS",
            "license": "0538283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.