Wichita Rehabilitation Medicine PA

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

Legal business name

WICHITA REHABILITATION MEDICINE PA

Practice address

3515 W Central Ave
Wichita, KS 67203-4921

Phone

(316) 755-0144

Fax

(844) 274-1204

NPI assigned

Aug 19, 2006

Organization subpart

No

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

Authorized official

Name

Blake C Veenis, M.D.NPI 1386758910

Title

Owner

Phone

(316) 755-0144

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in KS

Enrollment records 1

Practitioners 1

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

• Blake C Veenis, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Wichita, KS
  • NPI 1386758910
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649635200000",
    "number": "1851405302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3515 W CENTRAL AVE",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672034921",
            "telephone_number": "316-755-0144",
            "fax_number": "844-274-1204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3515 W CENTRAL AVE",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672034921",
            "telephone_number": "316-755-0144",
            "fax_number": "844-274-1204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WICHITA REHABILITATION MEDICINE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-19",
        "last_updated": "2022-04-11",
        "certification_date": "2022-04-11",
        "status": "A",
        "authorized_official_last_name": "VEENIS",
        "authorized_official_first_name": "BLAKE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "316-755-0144",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200360940A",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "DD4755",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wichita Radiological Group Prof Assoc
• Wichita Radiological Group Prof Assoc
• Wichita Radiological Group Prof Assoc
• Wichita Rehab and Wellness L.L.C
• Wichita Rehabilitation Hospital LLC
• Wichita RT Associates LLC
• Wichita Sleep Solutions LLC
• Wichita SNF Healthcare LLC
• Wichita State University
• Wichita State University

• Physical Medicine & Rehabilitation Physician in Wichita, KS
• Providers in Wichita, KS by specialty
• Physical Medicine & Rehabilitation Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2022; 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.