1063230803 NPI number — PREMIER HOSPITALISTS OF KANSAS, LLC

Table of content: VANESSA MARIA RIOS LMHC (NPI 1619751948)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063230803 NPI number — PREMIER HOSPITALISTS OF KANSAS, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PREMIER HOSPITALISTS OF KANSAS, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1063230803
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/04/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3515 W CENTRAL AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WICHITA
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
67203-4921
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
316-755-0144
Provider Business Mailing Address Fax Number:
844-274-1204

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
833 N VASSAR AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WICHITA
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
67208
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
316-755-0144
Provider Business Practice Location Address Fax Number:
844-274-1204
Provider Enumeration Date:
10/01/2024

Additional Information

Authorized Official

Authorized Official Last Name:
BURNS
Authorized Official First Name:
ELIZABETH
Authorized Official Middle Name:
RIAN
Authorized Official Title or Position:
DIRECTOR OF OPERATIONS
Authorized Official Telephone Number:
316-755-0144

Provider Taxonomy Codes

  • Taxonomy code: 208100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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