Susan L Carr, MD
Individual provider Active NPI Psychiatry Physician · Wichita, KS
NPI 1720041080 · NPPES record last updated Nov 30, 2007
Key facts
- NPI
- 1720041080
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatry Physician 2084P0800X
- License
- 0421888 (KS)
- Practice address
- 1001 N Minneapolis
Wichita, KS 67214-3124 - Phone
- (316) 293-2647
- Fax
- (316) 293-1863
- NPI assigned
- Apr 8, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050407001149 | KS | Practitioner - Psychiatry | 1052368305 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0421888 | KS | MD | Geriatric Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Kansas School of Medicine Wichita Medical Practice Assoc | Psychiatry | Current |
Accepting new patients |
| Preferred Medical Associates | Past | Accepting new patients |
Locations
1010 N Kansas St
Ste 3054
Wichita, KS 67214
Phone (316) 293-2647
929 N Saint Francis Ave
Wichita, KS 67214
Phone (316) 291-4396
1001 N Minneapolis St
Wichita, KS 67214
Phone (316) 293-1840
1010 N Kansas St
Ste 3049
Wichita, KS 67214
1010 N Kansas St
Wichita, KS 67214
Phone (316) 293-2622
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 0421888 | KS | Yes |
| Geriatric Psychiatry Physician | 2084P0805X | 0421888 | KS |
Addresses
Primary practice location
1001 N Minneapolis
Wichita, KS 67214-3124
Mailing address
1010 N Kansas
Suite #3049
Wichita, KS 67214-3199
Phone (316) 293-2647
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 040390 | Other | KS | BCBS |
Other providers in Wichita, KS
- Alexandra Carr
- Angela R Carr
- Carrie Carr
- Debra D Carr
- Michelle Carr
- Tammy Lee Carr
- Leslie Dianna Carreon
- Carrie Couture Lscsw LLC
- Stephanie June Carrigan
- Lauren Carrillo
All providers in Wichita, KS · Psychiatry Physician in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 30, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.