Organization Active NPI

Luke Carter, LP, LLC

  • Community/Behavioral Health Agency
  • Wichita, KS
National Provider Identifier
1538784848
Registry record updated Mar 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
LUKE CARTER, LP, LLC
Practice address
4601 E Douglas Ave Ste 207
Wichita, KS 67218-1032
Phone
(316) 337-5556
Fax
(316) 337-5531
NPI assigned
Jun 11, 2020
Last updated
Mar 28, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
LUKE CARTER, LP, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 28, 2021

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

Authorized official

Name
Mr. Diana Miskiewicz
Title
Credentialing
Phone
(316) 519-1877

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary
Adult Mental Health Clinic/Center 261QM0850X

Addresses

Primary practice location

4601 E Douglas Ave Ste 207
Wichita, KS 67218-1032

Mailing address

4601 E Douglas Ave Ste 207
Wichita, KS 67218-1032
Phone (316) 337-5556

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200706000814 KS Part B Supplier - Clinic/Group Practice 9436572757 Receives reassigned benefits from 1 practitioner
Practice locations: Wichita, KS

National Provider Directory

National Provider Directory
Part of
Luke Carter LP LLC

Locations

4601 E Douglas Ave
Ste 207
Wichita, KS 67218
Phone (316) 337-5556

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1591833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616889600000",
    "number": "1538784848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 E DOUGLAS AVE STE 207",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672181032",
            "telephone_number": "316-337-5556",
            "fax_number": "316-337-5531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4601 E DOUGLAS AVE STE 207",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672181032",
            "telephone_number": "316-337-5556",
            "fax_number": "316-337-5531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUKE CARTER, LP, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LUKE CARTER, LP, LLC",
        "enumeration_date": "2020-06-11",
        "last_updated": "2021-03-28",
        "certification_date": "2021-03-28",
        "status": "A",
        "authorized_official_last_name": "MISKIEWICZ",
        "authorized_official_first_name": "DIANA",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "316-519-1877",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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 Mar 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.