Provider Demographics
NPI:1770654063
Name:BABY WAVES, INC
Entity Type:Organization
Organization Name:BABY WAVES, INC
Other - Org Name:INSIGHT DIAGNOSTIC ULTRASOUND
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:POLLY
Authorized Official - Middle Name:S
Authorized Official - Last Name:LINDEMANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-636-9396
Mailing Address - Street 1:1861 N ROCK RD
Mailing Address - Street 2:STE 200
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67206-4200
Mailing Address - Country:US
Mailing Address - Phone:316-636-9396
Mailing Address - Fax:316-636-9396
Practice Address - Street 1:1861 N ROCK RD
Practice Address - Street 2:STE 200
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67206-4200
Practice Address - Country:US
Practice Address - Phone:316-636-9396
Practice Address - Fax:316-636-9396
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2471S1302X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonographyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS111219OtherBLUE CROSS BLUE SHIELD
KS130626Medicare ID - Type UnspecifiedPROVIDER ID NUMBER