Premier Phlebology, LLC

Primary specialty

Phlebology PhysicianTaxonomy code 202K00000X

Legal business name

PREMIER PHLEBOLOGY, LLC

Practice address

2350 N Greenwich Rd
Wichita, KS 67226-8269

Phone

(316) 617-5891

NPI assigned

Mar 6, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Paul CheatumNPI 1952367534

Title

President

Phone

(316) 617-5891

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KS

Enrollment records 1

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Paul Henry Cheatum, MD

  • Family Medicine Physician
  • Wichita, KS
  • NPI 1952367534
  Medicare reassignment Care Compare group Authorized official
• Sean-Carlo Prolago, PA

  • Physician Assistant
  • Wichita, KS
  • NPI 1619057791
  Medicare reassignment Care Compare group
• Kelly Harper, PA

  • Physician Assistant
  • Wichita, KS
  • NPI 1134201502
  Medicare reassignment
• Benny Lee Short, M.D.

  • Emergency Medicine Physician
  • Dodge City, KS
  • NPI 1104854553
  NPD (past)
• Shelley A McClure, M.D.

  • Obstetrics & Gynecology Physician
  • Connelly Springs, NC
  • NPI 1316995459

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1236297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236297600000",
    "number": "1740420520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 47055",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672017055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 N GREENWICH RD",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672268269",
            "telephone_number": "316-617-5891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER PHLEBOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-06",
        "last_updated": "2009-03-06",
        "status": "A",
        "authorized_official_last_name": "CHEATUM",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "316-617-5891",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "202K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Phlebology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Premier Hospitalists of Kansas, LLC
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• Premier Living by Warden LLC
• Premier Open MRI, Inc.
• Premier Pet Imaging of Wichita Inc
• Premier Physical Therapy, PA
• Premier Wellness Group LLC
• Premise Health of Kansas Medical PA
• Premise Health of Tennessee Medical PC
• Premonition Health LLC

• Phlebology Physician in Wichita, KS
• Providers in Wichita, KS by specialty
• Phlebology Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.