Individual provider Active NPI

Tiffany Lisa Lieurance, D.O.

  • Family Medicine Physician
  • Wichita, KS
National Provider Identifier
1790927549
Registry record updated Sep 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0533813 Issued in KS
Practice address
800 N Carriage Pkwy
Wichita, KS 67208-4508
Phone
(316) 858-5800
Fax
(316) 858-5868
NPI assigned
Mar 25, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2006016929 MO
Family Medicine Physician 207Q00000X 0533813 KS Primary

Addresses

Primary practice location

800 N Carriage Pkwy
Wichita, KS 67208-4508

Mailing address

800 N Carriage Pkwy
Wichita, KS 67208-4508
Phone (316) 858-5800

Other identifiers 1

IdentifierTypeStateIssuer
200612410AMedicaidKS

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090821000665 KS Practitioner - Family Practice 0042364200 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wichita Family Medicine Specialists, LLCGroup PAC ID 4082620489, 13 clinicians

Practice addresses (Care Compare)

800 N Carriage Pkwy
Wichita, KS 67208-4508
Phone (316) 858-5800

Hospital & facility affiliations

  • Wesley Medical Center Hospital, Wichita, KS, CCN 170123
  • Kansas Spine & Specialty Hospital, LLC Hospital, Wichita, KS, CCN 170196

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
2006016929MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wichita Family Medicine Specialists, LLC Family Medicine CurrentSince Sep 1, 2009 Accepting new patients

Locations

800 N Carriage Pkwy
Wichita, KS 67208
Phone (316) 858-5800

Interoperability endpoints

  • Direct secure messaging: tiffany.lieurance@khindirect.org

Organizations & group practices 1

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1237939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252540800000",
    "number": "1790927549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 N CARRIAGE PKWY",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672084508",
            "telephone_number": "316-858-5800",
            "fax_number": "316-858-5868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 N CARRIAGE PKWY",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672084508",
            "telephone_number": "316-858-5800",
            "fax_number": "316-858-5868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIEURANCE",
        "first_name": "TIFFANY",
        "middle_name": "LISA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-25",
        "last_updated": "2009-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2006016929",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "0533813",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200612410A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.