Active NPI
Enrique De la Guardia, M.D.
- Family Medicine Physician
- Fort Leavenworth, KS
National Provider Identifier
1891890778
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 16722
- Practice address
- 550 Pope Ave
Fort Leavenworth, KS 66027-2332 - Phone
- (913) 684-6000
- NPI assigned
- Sep 14, 2006
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 16722 | NE | Primary |
Addresses
Primary practice location
550 Pope Ave
Fort Leavenworth, KS 66027-2332
Mailing address
217 S 169TH Cir
Omaha, NE 68118-3041
Phone (402) 331-4257
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16722 | NE | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alegent Creighton Clinic | Family Medicine | Past | Accepting new patients |
| Heartland Emergicare, P.C. | Past | Accepting new patients | |
| Alegent Creighton Clinic | Family Medicine | Past | Accepting new patients |
| Joshua Medical Centers LLC | Family Medicine | Past | Accepting new patients |
Organizations & group practices 4
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.
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Family Medicine
-
- Urgent Care Clinic/Center
- Omaha, NE
- NPI 1033135595
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158192000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1891890778",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "217 S 169TH CIR",
"city": "OMAHA",
"state": "NE",
"postal_code": "681183041",
"telephone_number": "402-331-4257"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "550 POPE AVE",
"city": "FORT LEAVENWORTH",
"state": "KS",
"postal_code": "660272332",
"telephone_number": "913-684-6000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE LA GUARDIA",
"first_name": "ENRIQUE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NE",
"license": "16722",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Leavenworth, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.