NPIMap

Organization Active NPI

Libertas Corp.

Doing business as Freestate Health

  • Internal Medicine Physician
  • Wichita, KS
National Provider Identifier
1659822864
Registry record updated Dec 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
04-33447 Issued in KS
Legal business name
LIBERTAS CORP.
Doing business as
Freestate Health
Practice address
4723 E Douglas Ave
Wichita, KS 67218-1012
Phone
(800) 924-8140
Fax
(800) 924-8140
NPI assigned
Oct 24, 2016
Last updated
Dec 29, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2016

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

Authorized official

Name
Dr. Elisha Yaghmai, MDNPI 1063618544
Title
President
Phone
(800) 924-8140

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X 04-33447 KS
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 04-33447 KS Primary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X 04-33447 KS
Hospitalist PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208M00000X 04-33447 KS

Addresses

Primary practice location

4723 E Douglas Ave
Wichita, KS 67218-1012

Mailing address

4723 E Douglas Ave
Wichita, KS 67218-1012
Phone (800) 924-8140

Other names 1

  • Freestate Health Doing business as

National Provider Directory

National Provider Directory

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": "1477267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482969600000",
    "number": "1659822864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4723 E DOUGLAS AVE",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672181012",
            "telephone_number": "800-924-8140",
            "fax_number": "800-924-8140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4723 E DOUGLAS AVE",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672181012",
            "telephone_number": "800-924-8140",
            "fax_number": "800-924-8140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTAS CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-24",
        "last_updated": "2016-12-29",
        "status": "A",
        "authorized_official_last_name": "YAGHMAI",
        "authorized_official_first_name": "ELISHA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "800-924-8140",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": "KS",
            "license": "04-33447",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "KS",
            "license": "04-33447",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "KS",
            "license": "04-33447",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Hospitalist",
            "state": "KS",
            "license": "04-33447",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Freestate Health",
            "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 Dec 29, 2016; 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.