Wichita Vascular and Vein Center, LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

WICHITA VASCULAR AND VEIN CENTER, LLC

Doing business as

Wichita Vascular and Vein Center

Practice address

3161 N Webb Rd
Suite 110
Wichita, KS 67226

Phone

(316) 272-5800

Fax

(316) 272-5801

NPI assigned

Jan 23, 2019

Last updated

Jan 23, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Micha Perez

Title

Office Manager

Phone

(316) 272-5800

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Wichita Vascular and Vein Center Doing business as

Locations

Practitioners 1

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.

• Ghiyath Al-Tabbal, M.D.

  • Clinical Cardiac Electrophysiology Physician
  • Wichita, KS
  • NPI 1689890121
  NPD (past)

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

{
    "created_epoch": "1548201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548201600000",
    "number": "1427512573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3161 N WEBB RD",
            "address_2": "SUITE 110",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "67226",
            "telephone_number": "316-272-5800",
            "fax_number": "316-272-5801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3161 N WEBB RD",
            "address_2": "SUITE 110",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "67226",
            "telephone_number": "316-272-5800",
            "fax_number": "316-272-5801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WICHITA VASCULAR AND VEIN CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-23",
        "last_updated": "2019-01-23",
        "status": "A",
        "authorized_official_last_name": "PEREZ",
        "authorized_official_first_name": "MICHA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "316-272-5800",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "PENDING",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wichita Vascular and Vein Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Wichita Urology Group P.a.
• Wichita Urology Surgery Center LLC
• Wichita Vision Institute P.a.
• Wichita Wellness and Rehab LLC.
• Wichita Women's Initiative Network
• Asher J Wickell, LCMFT
• Breanna Wicker

• Clinic/Center in Wichita, KS
• Providers in Wichita, KS by specialty
• Clinic/Center in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.