Healthcare Provider Details

I. General information

NPI: 1477096097
Provider Name (Legal Business Name): CAREPOINT EMERGENCY MEDICINE KANSAS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2016
Last Update Date: 10/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 N HILLSIDE ST
WICHITA KS
67214-4910
US

IV. Provider business mailing address

10065 E HARVARD AVE SUITE 800
DENVER CO
80231-5968
US

V. Phone/Fax

Practice location:
  • Phone: 316-962-2000
  • Fax: 303-306-7753
Mailing address:
  • Phone: 303-306-7783
  • Fax: 303-306-7753

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code207PP0204X
TaxonomyPediatric Emergency Medicine (Emergency Medicine) Physician
License Number
License Number StateKS

VIII. Authorized Official

Name: DEBORAH SMITH
Title or Position: VP/GENERAL COUNSEL
Credential: J.D.
Phone: 303-436-2720