Eastern Kansas Health Care System

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

15-00217 Issued in KS

Legal business name

EASTERN KANSAS HEALTH CARE SYSTEM

Practice address

112 Tumbleweed Dr
Lawrence, KS 66049-4151

Phone

(785) 841-4707

NPI assigned

Jul 22, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Sirous Nourbakhsh, PA-C

Title

Physician Assistant

Phone

(785) 350-3111

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1750302832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 TUMBLEWEED DR",
            "city": "LAWRENCE",
            "state": "KS",
            "postal_code": "660494151",
            "telephone_number": "785-841-4707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 TUMBLEWEED DR",
            "city": "LAWRENCE",
            "state": "KS",
            "postal_code": "660494151",
            "telephone_number": "785-841-4707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN KANSAS HEALTH CARE SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NOURBAKHSH",
        "authorized_official_first_name": "SIROUS",
        "authorized_official_title_or_position": "PHYSICIAN ASSISTANT",
        "authorized_official_telephone_number": "785-350-3111",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KS",
            "license": "15-00217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physician Assistant in Lawrence, KS
• Providers in Lawrence, KS by specialty
• Physician Assistant in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.