Active NPI
Carolyn A Bland, PA
- Medical Physician Assistant
- Wichita, KS
National Provider Identifier
1679616478
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 15-01092
- Practice address
- 144 S Hillside St
Wichita, KS 67211-2154 - Phone
- (316) 682-9900
- Fax
- (316) 682-0311
- NPI assigned
- Feb 14, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 15-01092 | KS | Primary |
Addresses
Primary practice location
144 S Hillside St
Wichita, KS 67211-2154
Mailing address
144 S Hillside St
Wichita, KS 67211-2154
Phone (316) 682-9900
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200355270A | Medicaid | KS |
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: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20051221000644 | KS | Practitioner - Physician Assistant | 4587686340 | Reassigns benefits to 2 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Holy Family Medical Inc
Practice addresses (Care Compare)
144 S Hillside St
Wichita, KS 67211-2154
Phone 3166829900200
Hospital & facility affiliations
- Wesley Medical Center
- Ascension Via Christi Hospitals Wichita, Inc.
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15-01092 | KS | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Holy Family Medical, Inc. | Past | Accepting new patients |
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.
-
- Federally Qualified Health Center (FQHC)
- Wichita, KS
- NPI 1215659156
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Wichita, KS
- NPI 1154314789
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171411200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1423612800000",
"number": "1679616478",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "144 S HILLSIDE ST",
"city": "WICHITA",
"state": "KS",
"postal_code": "672112154",
"telephone_number": "316-682-9900",
"fax_number": "316-682-0311"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "144 S HILLSIDE ST",
"city": "WICHITA",
"state": "KS",
"postal_code": "672112154",
"telephone_number": "316-682-9900",
"fax_number": "316-682-0311"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLAND",
"first_name": "CAROLYN",
"middle_name": "A",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-14",
"last_updated": "2015-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "KS",
"license": "15-01092",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200355270A",
"state": "KS"
}
],
"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 Feb 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.