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CONCIERGE MEDICINE OF WICHITA LLC NPI 1326399205


NPI Information

NPI: 1326399205
Provider Name: CONCIERGE MEDICINE OF WICHITA LLC
Classification: Internal Medicine - 207R00000X
Entity Type: Organization

CLIA Number: 17D2062157

Address:
9449 E 21ST ST N
STE. 200
WICHITA, KS
ZIP 67206
Phone: (316) 462-1070
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CONCIERGE MEDICINE OF WICHITA LLC is an internal medicine in Wichita, KS. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. CONCIERGE MEDICINE OF WICHITA LLC NPI is 1326399205. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

9449 E 21ST ST N
STE. 200
WICHITA, KS
ZIP 67206-969
Phone: (316) 462-1070
Fax: (316) 462-1078

The provider's authorized official is Aly A Gadalla .
The authorized official title is Owner and has the following contact phone number (316) 462-1070.

The CLIA number assigned to this NPI record is 17D2062157 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/2/2012 and was last updated on 11/9/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207R00000XInternal Medicine04-29832KANSASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1PENDINGMEDICAIDKANSAS
2PENDINGMEDICARE PINKANSAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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