Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Prairie Endoscopy LLC

Organization Family Medicine Physician · NPI 1699189043

Prairie Endoscopy LLC is a Family Medicine Physician 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
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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