NPI Code Details Logo

NPI 1154744514

NPI 1154744514 : KANSAS EM I MEDICAL SERVICES PA : JUNCTION CITY, KS

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1154744514
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    KANSAS EM I MEDICAL SERVICES PA 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    01/21/2014
-----------------------------------------------------
    Last Update Date     |    03/30/2023
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    1102 SAINT MARYS RD 
-----------------------------------------------------
    City                 |    JUNCTION CITY
-----------------------------------------------------
    State                |    KS
-----------------------------------------------------
    Zip                  |    66441-4139
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    785-238-4131
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    13737 NOEL RD STE 1600
-----------------------------------------------------
    City                 |    DALLAS
-----------------------------------------------------
    State                |    TX
-----------------------------------------------------
    Zip                  |    75240-1331
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------
    Fax                  |    214-712-2444
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    OFFICER
-----------------------------------------------------
    Name                 |     KAREN  VAUGHN 
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    973-251-1132
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    363A00000X
-----------------------------------------------------
    Taxonomy Name        |    Physician Assistant
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
    Taxonomy Code        |    363L00000X
-----------------------------------------------------
    Taxonomy Name        |    Nurse Practitioner
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
    Taxonomy Code        |    207P00000X
-----------------------------------------------------
    Taxonomy Name        |    Emergency Medicine Physician
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.