Active NPI
Christopher J Dudley, P.A.
- Physician Assistant
- Wichita, KS
National Provider Identifier
1851540140
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 15-01304
- Practice address
- 2778 N Webb Rd
Wichita, KS 67226-8112 - Phone
- (316) 631-1600
- Fax
- (316) 631-1698
- NPI assigned
- Sep 11, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 15-01304 | KS | Primary |
Addresses
Primary practice location
2778 N Webb Rd
Wichita, KS 67226-8112
Mailing address
2778 N Webb Rd
Wichita, KS 67226-8112
Phone (316) 631-1600
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200573770A | Medicaid | KS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15-01304 | KS | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1221091200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1252454400000",
"number": "1851540140",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2778 N WEBB RD",
"city": "WICHITA",
"state": "KS",
"postal_code": "672268112",
"telephone_number": "316-631-1600",
"fax_number": "316-631-1698"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2778 N WEBB RD",
"city": "WICHITA",
"state": "KS",
"postal_code": "672268112",
"telephone_number": "316-631-1600",
"fax_number": "316-631-1698"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUDLEY",
"first_name": "CHRISTOPHER",
"middle_name": "J",
"credential": "P.A.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-09-11",
"last_updated": "2009-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "KS",
"license": "15-01304",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200573770A",
"state": "KS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wichita, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.