Provider Demographics
NPI:1952864589
Name:ASCENSION VIA CHRISTI CONCIERGE CARE INC
Entity Type:Organization
Organization Name:ASCENSION VIA CHRISTI CONCIERGE CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:BUESS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-268-8160
Mailing Address - Street 1:4815 E 31ST ST SOUTH
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67210
Mailing Address - Country:US
Mailing Address - Phone:316-613-5800
Mailing Address - Fax:
Practice Address - Street 1:4815 E 31ST ST SOUTH
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67210
Practice Address - Country:US
Practice Address - Phone:316-613-5800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ASCENSION VIA CHRISTI HOSPITALS WICHITA INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-04-10
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AETNAOtherAETNA