MEDICARE: LOTUS INTEGRATIVE HEALTH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	261QM1300X	Multi-Specialty Clinic/Center
2	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
3	363LF0000X	Family Nurse Practitioner
4	261QP2300X	Primary Care Clinic/Center

General Provider Information

NPI Number	:	1528725363
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOTUS INTEGRATIVE HEALTH

Provider Business Mailing Address
First Line	:	8101 COLLEGE BLVD STE 130
Second Line	:
City	:	OVERLAND PARK
State	:	KS
Zip	:	66210-2793
Country	:	US
Telephone Number	:	620-649-2505
Fax Number	:	669-204-0329

Provider Business Practice Location Address
First Line	:	6203 E OXFORD ST
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67220-5522
Country	:	US
Telephone Number	:	620-649-2505
Fax Number	:	669-204-0329

Authorized Official
Title or Position	:	APRN
Name	:	LACY SMITH
Credential	:	PMHNP-BC, FNP-BC
Telephone Number	:	620-649-2505

Provider Enumeration Date	:	11/29/2021
Last Update Date	:	05/05/2026

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