Anthem Wichita Management, LLC

Primary specialty

Alzheimer Center (Dementia Center)Taxonomy code 311500000X

Legal business name

ANTHEM WICHITA MANAGEMENT, LLC

Doing business as

Chisholm Place

Practice address

1859 N Webb Rd
Wichita, KS 67206-3413

Phone

(316) 558-5775

Fax

(316) 558-5763

NPI assigned

Nov 25, 2018

Last updated

Nov 25, 2018By the provider in NPPES

Organization subpart

Yes

Parent organization

AMC-WICHITA, LLCAs reported in NPPES

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

Authorized official

Name

Mrs. Melissa L Dinsmore, LNHA

Title

Executive Director

Phone

(316) 558-5775

Specialties & licenses 1

Addresses

Other names 1

• Chisholm Place Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Part of

Anthem Wichita Management LLC

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

{
    "created_epoch": "1543104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543104000000",
    "number": "1699244384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1859 N WEBB RD",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672063413",
            "telephone_number": "316-558-5775",
            "fax_number": "316-558-5763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1859 N WEBB RD",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672063413",
            "telephone_number": "316-558-5775",
            "fax_number": "316-558-5763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANTHEM WICHITA MANAGEMENT, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AMC-WICHITA, LLC",
        "enumeration_date": "2018-11-25",
        "last_updated": "2018-11-25",
        "status": "A",
        "authorized_official_last_name": "DINSMORE",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "316-558-5775",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LNHA"
    },
    "taxonomies": [
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chisholm Place",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Alzheimer Center (Dementia Center) in Wichita, KS
• Providers in Wichita, KS by specialty
• Alzheimer Center (Dementia Center) in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.

Verify at the official NPI Registry.