NPIMap

Organization Active NPI

Wesley Medical Center LLC

  • Pediatrics Physician
  • Wichita, KS
National Provider Identifier
1467409185
Registry record updated Oct 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
WESLEY MEDICAL CENTER LLC
Practice address
620 N Carriage Pkwy
Wichita, KS 67208-4501
Phone
(316) 962-3100
Fax
(316) 962-3164
NPI assigned
May 28, 2006
Organization subpart
Yes
Parent organization
WESLEY MEDICAL CENTER LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 20, 2022

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

Authorized official

Name
Nicole Castleberry
Title
Cfo
Phone
(316) 962-2055

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X Primary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X

Addresses

Primary practice location

620 N Carriage Pkwy
Wichita, KS 67208-4501

Mailing address

PO Box 47490
Wichita, KS 67201-7490
Phone (316) 962-3150

Other identifiers 3

IdentifierTypeStateIssuer
100327110FMedicaidKS
110453OtherKSBCBS OF KANSAS
100327110GMedicaidKS

Other names 1

  • Wesley Clinic Doing business as

National Provider Directory

National Provider Directory
Part of
Family Medicine Speciali

Locations

3243 E Murdock St
Ste Lvl-A
Wichita, KS 67208
Phone (316) 688-3150

Practitioners & affiliated clinicians

Practitioners 66

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 66

NPI Registry JSON

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

{
    "created_epoch": "1148774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666224000000",
    "number": "1467409185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 47490",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672017490",
            "telephone_number": "316-962-3150",
            "fax_number": "316-962-7334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 N CARRIAGE PKWY",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672084501",
            "telephone_number": "316-962-3100",
            "fax_number": "316-962-3164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESLEY MEDICAL CENTER LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WESLEY MEDICAL CENTER LLC",
        "enumeration_date": "2006-05-28",
        "last_updated": "2022-10-20",
        "certification_date": "2022-10-20",
        "status": "A",
        "authorized_official_last_name": "CASTLEBERRY",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "316-962-2055"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100327110F",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF KANSAS",
            "identifier": "110453",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100327110G",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wesley Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Wesley Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Oct 20, 2022; 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.