NPIMap

Organization Active NPI

Kansas Spine & Specialty Hospital, L.L.C.

  • General Acute Care Hospital
  • Wichita, KS
National Provider Identifier
1417950650
Registry record updated Mar 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
H087012 Issued in KS
Legal business name
KANSAS SPINE & SPECIALTY HOSPITAL, L.L.C.
Practice address
3333 N Webb Rd
Wichita, KS 67226-8123
Phone
(316) 462-5000
Fax
(316) 462-5268
NPI assigned
May 23, 2005
Last updated
Mar 3, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2023

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

Authorized official

Name
Jennifer Boyd Baldock
Title
Officer and Authorized Official
Phone
(615) 234-5954

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X H087012 KS Primary

Addresses

Primary practice location

3333 N Webb Rd
Wichita, KS 67226-8123

Mailing address

3333 N Webb Rd
Wichita, KS 67226-8123
Phone (316) 462-5000

Other identifiers 1

IdentifierTypeStateIssuer
200257840AMedicaidKS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031117000168 KS Part A Provider - Hospital 1456265230 1 other NPI on this enrollment
Practice locations: Wichita, KS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1417950650. Details of each certification follow.

Hospital certification: CCN 170196

Legal name
KANSAS SPINE & SPECIALTY HOSPITAL LLC
Doing business as
KANSAS SPINE & SPECIALTY HOSPITAL LLC
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Dec 29, 2003
Last certification
Apr 29, 2026
Beds
35
Ownership / control type
Physician ownership
Organization structure
LLCProprietary
Enrollment address
3333 N Webb Rd
Wichita, KS 67226-8123
Main/Primary Hospital Location
Hospital subgroups
Acute care, Specialty hospital

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Kansas Spine & Specialty Hospital, LLCCCN 170196 · All quality measures
Type
Acute Care Hospitals
Ownership
Physician
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
17D1019096Kansas Spine & Specialty Hospital, LLC3333 N Webb Road, Wichita, KS 67226AccreditationJul 27, 2027

National Provider Directory

National Provider Directory

Locations

3333 N Webb Rd
Wichita, KS 67226
Phone (316) 462-5000

Ownership & related parties

All disclosed owners & managing parties 17

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
SP Holdco I Inc Organization, Brentwood, TN Corporation 5% Or Greater Indirect Ownership Interest Sep 1, 2022 55%
Jennifer B Baldock Individual Corporate OfficerOfficer and Authorized Official Sep 1, 2022
2024 RWG III Irrevocable Trust Organization, Haysville, KS 5% Or Greater Direct Ownership Interest Oct 1, 2024 9.48%
FMR LLC Organization, Boston, MA LLC 5% Or Greater Indirect Ownership Interest Nov 21, 2022 7.26%
John Roger Dickerson Individual 5% Or Greater Indirect Ownership InterestMD Jan 1, 2007 9.74%
SP Management Services Inc Organization, Brentwood, TN Corporation Operational/Managerial Control Sep 1, 2022
Surgery Partners Inc Organization, Brentwood, TN Corporation 5% Or Greater Indirect Ownership Interest Sep 1, 2022 55%
Raymond Grundmeyer Individual 5% Or Greater Indirect Ownership InterestMD Oct 1, 2024 9.48%
2015 Chandra Tokala Irrevocable Trust Organization, Wichita, KS 5% Or Greater Direct Ownership Interest Dec 7, 2015 7.46%
2019 John R Dickerson Irrevocable Trust Organization, Wichita, KS 5% Or Greater Direct Ownership Interest Nov 8, 2019 9.74%
Surgery Center Holdings Inc Organization, Brentwood, TN Corporation 5% Or Greater Direct Ownership Interest Sep 1, 2022 55%
Other Sep 1, 2022 55%
Jennifer L Sanders Individual W-2 Managing EmployeeHospital Cfo Aug 13, 2018
Harrison R Bane Individual OtherNat'L GRP Pres & Cho Administrator Sep 1, 2024
Chandra Tokala Individual 5% Or Greater Indirect Ownership InterestMD Nov 5, 2001 7.46%
Bcpe Seminole Holdings II Intermediate LP Organization, Boston, MA 5% Or Greater Indirect Ownership Interest Mar 31, 2023 13.09%
Surgery Center Holdings LLC Organization, Brentwood, TN LLC 5% Or Greater Indirect Ownership Interest Sep 1, 2022 55%
Cynthia Meaux Individual Corporate OfficerHospital Ceo Apr 14, 2025
W-2 Managing EmployeeHospital Ceo Apr 14, 2025

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 25

Facilities that share an organizational owner with 5% or greater ownership or operational control.

  • Animas Surgical Hospital, LLC

    dba Animas Surgical Hospital

    • General Acute Care Hospital
    • Durango, CO
    • NPI 1508842964

    Bcpe Seminole Holdings II Intermediate LP, FMR LLC, SP Holdco I Inc, SP Management Services Inc, Surgery Center Holdings Inc, Surgery Center Holdings LLC, Surgery Partners Inc

    CMS ownership
  • Arizona Spine and Joint Hospital LLC
    • General Acute Care Hospital
    • Mesa, AZ
    • NPI 1396745832

    SP Holdco I Inc, Surgery Center Holdings Inc, Surgery Center Holdings LLC, Surgery Partners Inc

    CMS ownership
  • Brazos Valley Physicians Organization,Mso-LLC

    dba The Physicians Pain and Spine Centre

    • General Acute Care Hospital
    • Bryan, TX
    • NPI 1801817135

    Bcpe Seminole Holdings II Intermediate LP, SP Holdco I Inc, Surgery Center Holdings Inc, Surgery Center Holdings LLC, Surgery Partners Inc

    CMS ownership
  • CMSC, LLC

    dba Great Falls Clinic Hospital

    • General Acute Care Hospital
    • Great Falls, MT
    • NPI 1639109978

    Bcpe Seminole Holdings II Intermediate LP, FMR LLC, SP Holdco I Inc, SP Management Services Inc, Surgery Center Holdings Inc, Surgery Center Holdings LLC, Surgery Partners Inc

    CMS ownership
  • Lafayette Surgical Hospital LLC

    dba Lafayette Surgical Specialty Hospital

    • General Acute Care Hospital
    • Lafayette, LA
    • NPI 1134222565

    Bcpe Seminole Holdings II Intermediate LP, SP Holdco I Inc, Surgery Center Holdings Inc, Surgery Center Holdings LLC, Surgery Partners Inc

    CMS ownership
  • Lubbock Heart Hospital, LLC

    dba Lubbock Heart Hospital

    • General Acute Care Hospital
    • Lubbock, TX
    • NPI 1922001775

    Bcpe Seminole Holdings II Intermediate LP, SP Holdco I Inc, SP Management Services Inc, Surgery Center Holdings Inc, Surgery Center Holdings LLC, Surgery Partners Inc

    CMS ownership
  • Metdalspi, LLC

    dba Methodist Hospital for Surgery

    • General Acute Care Hospital
    • Addison, TX
    • NPI 1023338142

    SP Holdco I Inc, SP Management Services Inc, Surgery Center Holdings Inc, Surgery Center Holdings LLC, Surgery Partners Inc

    CMS ownership
  • Methodist McKinney Hospital LLC
    • General Acute Care Hospital
    • McKinney, TX
    • NPI 1952538431

    SP Holdco I Inc, SP Management Services Inc, Surgery Center Holdings Inc, Surgery Center Holdings LLC, Surgery Partners Inc

    CMS ownership
  • Midwest Orthopedic Specialty Hospital, LLC
    • Special Hospital
    • Franklin, WI
    • NPI 1861635971

    Bcpe Seminole Holdings II Intermediate LP, SP Holdco I Inc, Surgery Center Holdings Inc, Surgery Center Holdings LLC, Surgery Partners Inc

    CMS ownership
  • Midwest Surgical Hospital, L.L.C.
    • Special Hospital
    • Omaha, NE
    • NPI 1013122571

    Bcpe Seminole Holdings II Intermediate LP, SP Holdco I Inc, SP Management Services Inc, Surgery Center Holdings Inc, Surgery Center Holdings LLC, Surgery Partners Inc

    CMS ownership
  • North Carolina Specialty Hospital LLC
    • General Acute Care Hospital
    • Durham, NC
    • NPI 1437221785

    Bcpe Seminole Holdings II Intermediate LP, FMR LLC, SP Holdco I Inc, Surgery Center Holdings Inc, Surgery Center Holdings LLC, Surgery Partners Inc

    CMS ownership
  • North Idaho Day Surgery LLC

    dba Northwest Specialty Hospital

    • General Acute Care Hospital
    • Post Falls, ID
    • NPI 1104824739

    FMR LLC, SP Holdco I Inc, SP Management Services Inc, Surgery Center Holdings Inc, Surgery Center Holdings LLC, Surgery Partners Inc

    CMS ownership
View all 25

Practitioners & affiliated clinicians

Practitioners 7

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.

Affiliated clinicians 101

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 101

NPI Registry JSON

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

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677801600000",
    "number": "1417950650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 N WEBB RD",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672268123",
            "telephone_number": "316-462-5000",
            "fax_number": "316-462-5268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 N WEBB RD",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672268123",
            "telephone_number": "316-462-5000",
            "fax_number": "316-462-5268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KANSAS SPINE & SPECIALTY HOSPITAL, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-23",
        "last_updated": "2023-03-03",
        "certification_date": "2023-03-03",
        "status": "A",
        "authorized_official_last_name": "BALDOCK",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "BOYD",
        "authorized_official_title_or_position": "OFFICER AND AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "615-234-5954"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "KS",
            "license": "H087012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200257840A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.