Accident and Recovery Clinic

Primary specialty

Occupational Medicine PhysicianTaxonomy code 2083X0100X

License

04-29832 Issued in KS

Legal business name

ACCIDENT AND RECOVERY CLINIC

Practice address

3810 W Bounous St
Wichita, KS 67213-1203

Phone

(316) 686-0400

Fax

(316) 686-0448

NPI assigned

Aug 11, 2015

Last updated

Aug 11, 2015By 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

Dr. Aly A Gadalla, MD

Title

Owner

Phone

(316) 686-0400

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1439251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439251200000",
    "number": "1851767032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3810 W BOUNOUS ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672131203",
            "telephone_number": "316-686-0400",
            "fax_number": "316-686-0448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3810 W BOUNOUS ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672131203",
            "telephone_number": "316-686-0400",
            "fax_number": "316-686-0448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACCIDENT AND RECOVERY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-11",
        "last_updated": "2015-08-11",
        "status": "A",
        "authorized_official_last_name": "GADALLA",
        "authorized_official_first_name": "ALY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "316-686-0400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "KS",
            "license": "04-29832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2015; 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.