NPIMap

Organization Active NPI

Emergency Specialty Services Affiliates, LLC

  • Emergency Medicine Physician
  • Great Bend, KS
National Provider Identifier
1922269174
Registry record updated Jan 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
EMERGENCY SPECIALTY SERVICES AFFILIATES, LLC
Practice address
3515 Broadway Ave
Great Bend, KS 67530-3633
Phone
(316) 684-3838
NPI assigned
Jun 20, 2008
Last updated
Jan 16, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2009

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

Authorized official

Name
Steven Henson, MDNPI 1518923580
Title
Owner
Phone
(316) 684-3838

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X NU Primary

Addresses

Primary practice location

3515 Broadway Ave
Great Bend, KS 67530-3633

Mailing address

6896 W Snowville Rd
Brecksville, OH 44141-3214

Other identifiers 1

IdentifierTypeStateIssuer
200576730AMedicaidKS

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1213920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1232064000000",
    "number": "1922269174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6896 W SNOWVILLE RD",
            "city": "BRECKSVILLE",
            "state": "OH",
            "postal_code": "441413214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3515 BROADWAY AVE",
            "city": "GREAT BEND",
            "state": "KS",
            "postal_code": "675303633",
            "telephone_number": "316-684-3838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMERGENCY SPECIALTY SERVICES AFFILIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-20",
        "last_updated": "2009-01-16",
        "status": "A",
        "authorized_official_last_name": "HENSON",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "316-684-3838",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200576730A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Bend, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 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.

Verify at the official NPI Registry.