Individual provider Active NPI

John L Smith, MD

  • Surgery Physician
  • Wichita, KS
National Provider Identifier
1669470290
Registry record updated Nov 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
04-16074 Issued in KS
Practice address
818 N Emporia St
Suite 200
Wichita, KS 67214-3729
Phone
(316) 263-0296
Fax
(316) 263-9523
NPI assigned
Jul 8, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Transplant Surgery Physician 204F00000X 0416074 KS
Surgery Physician 208600000X 04-16074 KS Primary

Addresses

Primary practice location

818 N Emporia St
Suite 200
Wichita, KS 67214-3729

Mailing address

818 N Emporia St
Suite 200
Wichita, KS 67214-3729
Phone (316) 263-0296

Other identifiers 1

IdentifierTypeStateIssuer
100162260BMedicaidKS

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
I20050513000479 KS Practitioner - General Surgery 1355382995 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Kansas School of Med (KC/Wich/Sal), 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ascension Via Christi Hospitals Wichita IncGroup PAC ID 5799696944, 123 clinicians

Practice addresses (Care Compare)

707 N Emporia St
Wichita, KS 67214-3707
Phone (316) 858-3460

Hospital & facility affiliations

  • Ascension Via Christi Hospitals Wichita, Inc. Hospital, Wichita, KS, CCN 170122

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0416074KSMDTransplant Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Via Christi Hospitals Wichita Inc. CurrentSince Jul 18, 2018 Accepting new patients
Ascension Via Christi Hospitals Wichita Inc. CurrentSince Jul 18, 2018 Accepting new patients
Via Christi Hospitals Wichita, Inc. Past Accepting new patients

Locations

707 N Emporia St
Wichita, KS 67214
Phone (316) 858-3460

1100 N Saint Francis Ave
Fl 4
Wichita, KS 67214
Phone (316) 268-8080

929 N Saint Francis Ave
Wichita, KS 67214
Phone (316) 291-4396

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/20807/brand/4/csg/1/fhir/r4

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542153600000",
    "number": "1669470290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "818 N EMPORIA ST",
            "address_2": "SUITE 200",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672143729",
            "telephone_number": "316-263-0296",
            "fax_number": "316-263-9523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "818 N EMPORIA ST",
            "address_2": "SUITE 200",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672143729",
            "telephone_number": "316-263-0296",
            "fax_number": "316-263-9523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JOHN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-08",
        "last_updated": "2018-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204F00000X",
            "taxonomy_group": "",
            "desc": "Transplant Surgery",
            "state": "KS",
            "license": "0416074",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "KS",
            "license": "04-16074",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100162260B",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.