Healthcare Provider Details

I. General information

NPI: 1285026351
Provider Name (Legal Business Name): HOUSE CALL MEDICAL SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2015
Last Update Date: 09/11/2025
Certification Date: 09/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

245 N WACO ST STE 220
WICHITA KS
67202-1102
US

IV. Provider business mailing address

245 N WACO ST STE 220
WICHITA KS
67202-1102
US

V. Phone/Fax

Practice location:
  • Phone: 316-722-2138
  • Fax: 833-464-2530
Mailing address:
  • Phone: 316-722-2138
  • Fax: 833-464-2530

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number76470
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number80145
License Number StateKS
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number46278
License Number StateKS

VIII. Authorized Official

Name: MARCI BACON
Title or Position: BUSINESS MANAGER/BILLING SPECIALIST
Credential:
Phone: 316-722-2138