Organization Active NPI

Wheatland Medical Clinic PA

  • Family Medicine Physician
  • Wichita, KS
National Provider Identifier
1891749024
Registry record updated Mar 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
WHEATLAND MEDICAL CLINIC PA
Practice address
5735 W Macarthur Rd
Wichita, KS 67215-8404
Phone
(316) 524-9400
Fax
(316) 524-9800
NPI assigned
May 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2010

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

Authorized official

Name
Diana K Ketterman, MD
Title
President
Phone
(316) 524-9400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X KS Primary

Addresses

Primary practice location

5735 W Macarthur Rd
Wichita, KS 67215-8404

Mailing address

5735 W Macarthur Rd
Wichita, KS 67215-8404
Phone (316) 524-9400

Other identifiers 1

IdentifierTypeStateIssuer
110692OtherKSBC/BS

National Provider Directory

National Provider Directory

Locations

5735 W MacArthur Rd
Wichita, KS 67215
Phone (316) 524-9400

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1269302400000",
    "number": "1891749024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5735 W MACARTHUR RD",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672158404",
            "telephone_number": "316-524-9400",
            "fax_number": "316-524-9800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5735 W MACARTHUR RD",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672158404",
            "telephone_number": "316-524-9400",
            "fax_number": "316-524-9800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHEATLAND MEDICAL CLINIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-20",
        "last_updated": "2010-03-23",
        "status": "A",
        "authorized_official_last_name": "KETTERMAN",
        "authorized_official_first_name": "DIANA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "316-524-9400",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "KS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "110692",
            "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 Mar 23, 2010; 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.