Individual provider Active NPI

Susan R. George, PA

  • Medical Physician Assistant
  • Wichita, KS
National Provider Identifier
1821056797
Registry record updated Sep 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
15000887 Issued in KS
Practice address
9300 E 29TH St N
Suite 310
Wichita, KS 67226-2182
Phone
(316) 858-9000
Fax
(316) 858-9005
NPI assigned
May 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 15000887 KS Primary

Addresses

Primary practice location

9300 E 29TH St N
Suite 310
Wichita, KS 67226-2182

Mailing address

9300 E 29TH St N
Suite 310
Wichita, KS 67226-2182
Phone (316) 858-9000

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050420000396 KS Practitioner - Physician Assistant 2961440011 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1001 N Minneapolis St
Wichita, KS 67214-3127
Phone (316) 293-2647

1010 N Kansas St
Wichita, KS 67214-3124

8533 E 32ND St N
Wichita, KS 67226-2611
Phone (316) 293-2622

Hospital & facility affiliations

  • Ascension Via Christi Hospitals Wichita, Inc. Hospital, Wichita, KS, CCN 170122
  • Wesley Medical Center Hospital, Wichita, KS, CCN 170123

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
15000887KSMDMedical Physician Assistant

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 3

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": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283817600000",
    "number": "1821056797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9300 E 29TH ST N",
            "address_2": "SUITE 310",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672262182",
            "telephone_number": "316-858-9000",
            "fax_number": "316-858-9005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9300 E 29TH ST N",
            "address_2": "SUITE 310",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672262182",
            "telephone_number": "316-858-9000",
            "fax_number": "316-858-9005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEORGE",
        "first_name": "SUSAN",
        "middle_name": "R.",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-02",
        "last_updated": "2010-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "KS",
            "license": "15000887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.