Provider Demographics
NPI:1669471710
Name:ASCENSION VIA CHRISTI IMAGING MANHATTAN, LLC
Entity Type:Organization
Organization Name:ASCENSION VIA CHRISTI IMAGING MANHATTAN, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CNO
Authorized Official - Prefix:MRS
Authorized Official - First Name:CARLA
Authorized Official - Middle Name:
Authorized Official - Last Name:YOST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-904-6907
Mailing Address - Street 1:PO BOX 1329
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66505
Mailing Address - Country:US
Mailing Address - Phone:785-776-3322
Mailing Address - Fax:785-776-1988
Practice Address - Street 1:1133 COLLEGE AVE
Practice Address - Street 2:BLDG G SUITE 110
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-2770
Practice Address - Country:US
Practice Address - Phone:785-776-3322
Practice Address - Fax:785-532-9036
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-20
Last Update Date:2019-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QM1200X, 261QR0200X
KSH081003261QM1200X, 261QR0200X, 261QR0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
No261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)
No261QR0206XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mammography
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100411700BMedicaid
KS130444Medicare PIN