Waterfront Surgery Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

WATERFRONT SURGERY CENTER LLC

Practice address

1540 N. Lindberg Circle
Wichita, KS 67206

Phone

(316) 249-4943

NPI assigned

Mar 14, 2023

Organization subpart

No

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

Authorized official

Name

Brandon Kingrey, MD

Title

Owner

Phone

(316) 249-4943

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KS

Enrollment records 1

Listed as

Waterfront Surgery Center LLCCCN 17C0001901

Medicare certification status

ActiveFrom the Provider of Services file

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

CLIA laboratory certificates

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

{
    "created_epoch": "1678752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711584000000",
    "number": "1467153718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1540 N LINDBERG CIR",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672066400",
            "telephone_number": "316-249-4943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1540 N. LINDBERG CIRCLE",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "67206",
            "telephone_number": "316-249-4943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATERFRONT SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-14",
        "last_updated": "2024-03-28",
        "certification_date": "2024-03-28",
        "status": "A",
        "authorized_official_last_name": "KINGREY",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "316-249-4943",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Breanne Larae Wasinger
• Marcia Wasinger, LCMFT
• Nicholas Wasinger
• William A Waswick, MD
• Waterfront Inn Assisted Living, L.L.C.
• Ashlee Marie Waters
• Marsha K Waters, APRN
• Ziara Watie
• Blair D G Watkins, DNP APRN FNP-C BSPH
• Elizabeth E Watkins, SLP

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.