Provider Demographics
NPI:1063453991
Name:ASCENSION MEDICAL GROUP VIA CHRISTI, PA
Entity type:Organization
Organization Name:ASCENSION MEDICAL GROUP VIA CHRISTI, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR,PATIENT FINANCIAL SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:SUZANN
Authorized Official - Middle Name:M
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-719-1201
Mailing Address - Street 1:PO BOX 2969
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67201-2969
Mailing Address - Country:US
Mailing Address - Phone:316-268-5178
Mailing Address - Fax:
Practice Address - Street 1:3311 E MURDOCK ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67208
Practice Address - Country:US
Practice Address - Phone:316-689-9135
Practice Address - Fax:316-689-9102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-10
Last Update Date:2019-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSCC8489OtherMEDICARE RAILROAD
KS003719OtherBCBS
KSCC8488OtherMEDICARE RAILROAD
KS100080310AMedicaid
KS200726520IMedicaid
KSCU0056OtherMEDICARE RAILROAD
KS003719OtherBCBS