Provider Demographics
NPI:1144248899
Name:SANDHILL ORTHOPAEDIC & SPORTSMEDICINE, LLC
Entity type:Organization
Organization Name:SANDHILL ORTHOPAEDIC & SPORTSMEDICINE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESSOFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:HALLIE
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:NUSSER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-275-8400
Mailing Address - Street 1:101 E FULTON ST
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67846-5455
Mailing Address - Country:US
Mailing Address - Phone:620-275-8400
Mailing Address - Fax:620-275-2687
Practice Address - Street 1:101 E FULTON ST
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:KS
Practice Address - Zip Code:67846-5455
Practice Address - Country:US
Practice Address - Phone:620-275-8400
Practice Address - Fax:620-275-2687
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-21693174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS059344Medicare ID - Type UnspecifiedDR. BAUGHMAN INDIVIDUAL #
KS110323Medicare ID - Type Unspecified
KSB69323Medicare UPIN