Individual provider Active NPI

Jonathan David Scrafford, M.D.

  • Obstetrics & Gynecology Physician
  • Wichita, KS
National Provider Identifier
1639411325
Registry record updated Jan 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
04-39512 Issued in KS
Practice address
1515 S Clifton Ave
Wichita, KS 67218-2900
Phone
(316) 636-1550
Fax
(316) 636-1569
NPI assigned
Mar 20, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 15, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Obstetrics & Gynecology Physician 207V00000X 04-39512 KS Primary

Addresses

Primary practice location

1515 S Clifton Ave
Wichita, KS 67218-2900

Mailing address

1515 S Clifton Ave
Wichita, KS 67218-2900
Phone (316) 636-1550

Other practice location 1

1284 Fifield Pl
Falcon Heights, MN 55108-1103
Phone (651) 528-7947

Other identifiers 1

IdentifierTypeStateIssuer
201157750AMedicaidKS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170720000507 KS Practitioner - Obstetrics/Gynecology 3870898117 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ascension Medical Group Via Christi PAGroup PAC ID 2961314497, 184 clinicians

Practice addresses (Care Compare)

3311 E Murdock St
Wichita, KS 67208-3054
Phone (316) 689-9349

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
04-39512KSMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Medical Group Via Christi, PA CurrentSince Jul 1, 2017 Accepting new patients
Ascension Medical Group Via Christi, PA CurrentSince Jul 1, 2017 Accepting new patients
Kingman County Family Medicine,LLC Past Accepting new patients
Ascension Via Christi Hospitals Wichita Inc. Past Accepting new patients
Ascension Medical Group Via Christi, PA Past Accepting new patients

Locations

3311 E Murdock St
Wichita, KS 67208
Phone (316) 689-9107

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1363737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547510400000",
    "number": "1639411325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 S CLIFTON AVE",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672182900",
            "telephone_number": "316-636-1550",
            "fax_number": "316-636-1569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 S CLIFTON AVE",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672182900",
            "telephone_number": "316-636-1550",
            "fax_number": "316-636-1569"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1284 Fifield Pl",
            "address_purpose": "LOCATION",
            "city": "Falcon Heights",
            "state": "MN",
            "postal_code": "551081103",
            "country_code": "US",
            "telephone_number": "651-528-7947",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCRAFFORD",
        "first_name": "JONATHAN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-03-20",
        "last_updated": "2019-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "KS",
            "license": "04-39512",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201157750A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.