Organization Active NPI

Prairie Health and Wellness, LLC

  • Clinic/Center
  • Wichita, KS
National Provider Identifier
1477926301
Registry record updated Aug 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
PRAIRIE HEALTH AND WELLNESS, LLC
Practice address
12115 E 21St St N Ste 107
Wichita, KS 67206-3571
Phone
(316) 440-7000
Fax
(316) 440-7006
NPI assigned
Oct 30, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2024

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

Authorized official

Name
Laura Johnston
Title
Director of Operations
Phone
(316) 440-7000

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
NaturopathGroup: 193200000X MULTI-SPECIALTY GROUP 175F00000X 2100037 KS
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

12115 E 21St St N Ste 107
Wichita, KS 67206-3571

Mailing address

12115 E 21St St N Ste 107
Wichita, KS 67206-3571
Phone (316) 440-7000

Other names 1

  • Prairie Health and Wellness Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
17D2101389Prairie Health and Wellness12115 E 21St Street N, Suite 107, Wichita, KS 67206Certificate of waiverAug 31, 2027

National Provider Directory

National Provider Directory

Locations

12107 E 21st St N
Wichita, KS 67206
Phone (316) 201-6656

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1446163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724025600000",
    "number": "1477926301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12115 E 21ST ST N STE 107",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672063571",
            "telephone_number": "316-440-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12115 E 21ST ST N STE 107",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672063571",
            "telephone_number": "316-440-7000",
            "fax_number": "316-440-7006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRAIRIE HEALTH AND WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-30",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-19",
        "status": "A",
        "authorized_official_last_name": "JOHNSTON",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "316-440-7000"
    },
    "taxonomies": [
        {
            "code": "175F00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Naturopath",
            "state": "KS",
            "license": "2100037",
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prairie Health and Wellness",
            "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 Aug 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.