Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Prairie Endoscopy LLC

Organization Family Medicine Physician · NPI 1699189043

Prairie Endoscopy LLC provides Family Medicine Physician services in Wichita, Kansas. Licensed in Kansas. Registered with an NPI since 2014.

Licensed in
KS
In the registry since
2014
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

12115 E 21st St N Ste 107
Wichita, KS 67206-3567 Not confirmed with CMS for 12 years — call before visiting
Phone: (316) 440-7000
Fax: (316) 440-7006
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Endoscopy Clinic/Center (primary) Taxonomy 261QE0800X · Licence 04-30240 (KS)
Family Medicine Physician Taxonomy 207Q00000X · Licence 04-30240 (KS)

Record details

NPI number1699189043
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jeffrey Davis — Sole Owner · (316) 440-7000
NPI enumeratedJune 13, 2014
Last updated in NPPESJune 25, 2014
Mailing address12115 E 21st St N, Suite 107, Wichita, KS 67206-3567

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