Organization Active NPI

KBS Medical Kansas PA

  • Psychiatry Physician
  • Wichita, KS
National Provider Identifier
1457210874
Registry record updated Apr 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
KBS MEDICAL KANSAS PA
Practice address
4601 E Douglas Ave Ste 150
Wichita, KS 67218-1011
Phone
(909) 679-3482
Fax
(844) 440-2410
NPI assigned
Jan 21, 2026
Last updated
Apr 16, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2026

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

Authorized official

Name
Lisa Kennedy
Title
Coo
Phone
(212) 620-3053

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Psychiatry & Neurology) Physician 2084A0401X NU
Psychiatry Physician 2084P0800X NU Primary

Addresses

Primary practice location

4601 E Douglas Ave Ste 150
Wichita, KS 67218-1011

Mailing address

169 Madison Ave Ste 15824
New York, NY 10016-5101
Phone (909) 679-3482

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1768953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776297600000",
    "number": "1457210874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 MADISON AVE STE 15824",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100165101",
            "telephone_number": "909-679-3482",
            "fax_number": "844-440-2410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4601 E DOUGLAS AVE STE 150",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672181011",
            "telephone_number": "909-679-3482",
            "fax_number": "844-440-2410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KBS MEDICAL KANSAS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-21",
        "last_updated": "2026-04-16",
        "certification_date": "2026-04-16",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "212-620-3053"
    },
    "taxonomies": [
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2026; 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.