Healthcare Provider Details

I. General information

NPI: 1528725363
Provider Name (Legal Business Name): LOTUS INTEGRATIVE HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2021
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 W CHOUTEAU AVE
SUBLETTE KS
67877-6738
US

IV. Provider business mailing address

8101 COLLEGE BLVD STE 130
OVERLAND PARK KS
66210-2793
US

V. Phone/Fax

Practice location:
  • Phone: 620-649-2505
  • Fax: 669-204-0329
Mailing address:
  • Phone: 620-649-2505
  • Fax: 669-204-0329

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LACY SMITH
Title or Position: APRN
Credential: PMHNP-BC, FNP-BC
Phone: 620-649-2505