Individual provider Active NPI

Connie M Marsh, MD

  • Psychiatry Physician
  • Wichita, KS
National Provider Identifier
1306808092
Registry record updated Nov 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
0417613 Issued in KS
Practice address
1001 N Minneapolis
Wichita, KS 67214-3124
Phone
(316) 293-2647
Fax
(316) 293-1863
NPI assigned
Apr 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 0417613 KS Primary
Geriatric Psychiatry Physician 2084P0805X 0417613 KS

Addresses

Primary practice location

1001 N Minneapolis
Wichita, KS 67214-3124

Mailing address

1010 N Kansas
Suite #3049
Wichita, KS 67214-3199
Phone (316) 293-2647

Other identifiers 1

IdentifierTypeStateIssuer
019672OtherKSBCBS

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
I20050408000584 KS Practitioner - PsychiatryPractitioner - Geriatric Psychiatry 2860439106 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0417613KSMDGeriatric Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Kansas School of Medicine Wichita Medical Practice Assoc Psychiatry CurrentSince Dec 1, 1996 Accepting new patients

Locations

1010 N Kansas St
Ste 3054
Wichita, KS 67214
Phone (316) 293-2647

1010 N Kansas St
Ste 3049
Wichita, KS 67214

1010 N Kansas St
Wichita, KS 67214
Phone (316) 293-2622

1001 N Minneapolis St
Wichita, KS 67214
Phone (316) 293-1840

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

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196380800000",
    "number": "1306808092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 N KANSAS",
            "address_2": "SUITE #3049",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672143199",
            "telephone_number": "316-293-2647",
            "fax_number": "316-293-1863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 N MINNEAPOLIS",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672143124",
            "telephone_number": "316-293-2647",
            "fax_number": "316-293-1863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSH",
        "first_name": "CONNIE",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-06",
        "last_updated": "2007-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "KS",
            "license": "0417613",
            "primary": true
        },
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "KS",
            "license": "0417613",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "019672",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.