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	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1922016492
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	:	PRACTICE ADMINISTRATOR
Name	:	KARLA NICHOLS
Credential	:
Telephone Number	:	316-219-8299

Provider Enumeration Date	:	08/03/2006
Last Update Date	:	03/17/2026

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