MEDICARE: KANSAS JOINT & SPINE SPECIALISTS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	4684200001	OTHER		DMERC

General Provider Information

NPI Number	:	1265479059
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KANSAS JOINT & SPINE SPECIALISTS, LLC

Provider Business Mailing Address
First Line	:	10100 E SHANNON WOODS CIR STE 100
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67226-4106
Country	:	US
Telephone Number	:	316-219-8299
Fax Number	:	855-587-4501

Provider Business Practice Location Address
First Line	:	10100 E SHANNON WOODS ST
Second Line	:	SUITE 100
City	:	WICHITA
State	:	KS
Zip	:	67226-4104
Country	:	US
Telephone Number	:	316-219-8299
Fax Number	:	316-219-5899

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	STEFANIE D HARPER
Credential	:
Telephone Number	:	316-440-9504

Provider Enumeration Date	:	06/01/2006
Last Update Date	:	03/17/2026

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Directions to “KANSAS JOINT & SPINE SPECIALISTS, LLC ” Practice Location

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