Individual provider Active NPI

Philip Louis Rambo, PHD

  • Clinical Neuropsychologist
  • Wichita, KS
National Provider Identifier
1407290497
Registry record updated Apr 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
1062 Issued in WV
Practice address
801 E Douglas Ave Ste 200
Wichita, KS 67202-3548
Phone
(316) 361-6885
NPI assigned
Apr 22, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 1062 WV
Clinical Neuropsychologist 103G00000X 1062 WV Primary

Addresses

Primary practice location

801 E Douglas Ave Ste 200
Wichita, KS 67202-3548

Mailing address

801 E Douglas Ave Ste 200
Wichita, KS 67202-3548
Phone (918) 289-8186

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230412000677 KS Practitioner - Clinical Psychologist 1557661568 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1062WVMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Great Plains Cognition Clinical Neuropsychologist CurrentSince Sep 24, 2021 Accepting new patients

Locations

801 E Douglas Ave
Ste 200
Wichita, KS 67202
Phone (316) 361-6885

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": "1366588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745539200000",
    "number": "1407290497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 E DOUGLAS AVE STE 200",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672023548",
            "telephone_number": "918-289-8186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 E DOUGLAS AVE STE 200",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672023548",
            "telephone_number": "316-361-6885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAMBO",
        "first_name": "PHILIP",
        "middle_name": "LOUIS",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-22",
        "last_updated": "2025-04-25",
        "certification_date": "2025-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WV",
            "license": "1062",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "WV",
            "license": "1062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.