MEDICARE: ERAS HEALTH

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	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1134071574
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ERAS HEALTH

Provider Business Mailing Address
First Line	:	11124 E 28TH ST N STE 105
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67226-4562
Country	:	US
Telephone Number	:	316-247-1065
Fax Number	:	316-462-5752

Provider Business Practice Location Address
First Line	:	11124 E 28TH ST N STE 105
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67226-4562
Country	:	US
Telephone Number	:	316-247-1065
Fax Number	:	316-462-5752

Authorized Official
Title or Position	:	OWNER
Name	:	ANGELA THEOBALD
Credential	:	FNP
Telephone Number	:	316-204-9258

Provider Enumeration Date	:	02/10/2026
Last Update Date	:	02/10/2026

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Directions to “ERAS HEALTH ” Practice Location

Language	Start Address	Practice Location

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