Lifeline Stop Smoking Clinic, LLC

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

License

17663 Issued in KS

Legal business name

LIFELINE STOP SMOKING CLINIC, LLC

Practice address

650 N Carriage Pkwy
Suite 135
Wichita, KS 67208-4507

Phone

(316) 640-0804

Fax

(316) 685-8247

NPI assigned

Nov 2, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Timothy Scanlan, MD

Title

Owner/Managing Partner

Phone

(316) 640-0804

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Lifeline Stop Smoking Clinic LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Lifeline Stop Smoking Clinic, LLC

  • Health Service Clinic/Center
  • Overland Park, KS
  • NPI 1427137538
  NPD tax ID

Locations

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1477632578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 N CARRIAGE PKWY",
            "address_2": "SUITE 135",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672084507",
            "telephone_number": "316-640-0804",
            "fax_number": "316-685-8247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 N CARRIAGE PKWY",
            "address_2": "SUITE 135",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672084507",
            "telephone_number": "316-640-0804",
            "fax_number": "316-685-8247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFELINE STOP SMOKING CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SCANLAN",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "OWNER/MANAGING PARTNER",
        "authorized_official_telephone_number": "316-640-0804",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "KS",
            "license": "17663",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NON-PAR. PROVIDER #",
            "identifier": "103516",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.