MEDICARE: HEARTLAND INTERVENTIONAL PAIN AND SPINE

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	208VP0000X	Pain Medicine Physician
2	207LP2900X	Pain Medicine (Anesthesiology) Physician

General Provider Information

NPI Number	:	1518753292
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEARTLAND INTERVENTIONAL PAIN AND SPINE

Provider Business Mailing Address
First Line	:	2450 N WOODLAWN BLVD
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67220-3902
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2450 N WOODLAWN BLVD
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67220-3902
Country	:	US
Telephone Number	:	405-227-7479
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	BRIAN GOENTZEL
Credential	:	MD
Telephone Number	:	405-227-7479

Provider Enumeration Date	:	04/17/2025
Last Update Date	:	04/17/2025

Similar Medicare Providers

1609831734 — ANTONIO L OSIO MD PA
Practice Location Address:

2456 N WOODLAWN ST
WICHITA, KS
67220-3902

Practice Phone: 316-689-8677
Practice Fax: 316-688-1072

1578908299 — KANSAS ORTHOPAEDIC CENTER, PA
Practice Location Address:

2450 N WOODLAWN BLVD
WICHITA, KS
67220-3902

Practice Phone: 316-838-2020
Practice Fax:

1598174807 — KANSAS ORTHOPAEDIC CENTER, P.A.
Practice Location Address:

2450 N WOODLAWN BLVD
WICHITA, KS
67220-3902

Practice Phone: 316-838-2020
Practice Fax:

1235204025 — DR. FREDERIC ORVILLE FARRELL M.D.
Practice Location Address:

5 BARCELONA CT
WICHITA FALLS, TX
76308-3902

Practice Phone: 940-691-4937
Practice Fax:

1003770488 — SIOBHAN HEADMAN
Practice Location Address:

2600 N WOODLAWN BLVD
WICHITA, KS
67220-2729

Practice Phone: 316-838-2883
Practice Fax:

1124981253 — LAURYN GOODE
Practice Location Address:

5318 LOOMAN ST
WICHITA, KS
67220-4020

Practice Phone: 316-259-8057
Practice Fax:

Directions to “HEARTLAND INTERVENTIONAL PAIN AND SPINE ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.