Active NPI
KBS Medical Kansas PA
- Psychiatry Physician
- Wichita, KS
National Provider Identifier
1457210874
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- 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, 2026
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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 DirectoryNPI 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.