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

Prime Healthcare Physician Services - Providence Inc

Organization General Practice Physician · NPI 1972119741

Prime Healthcare Physician Services - Providence Inc is a General Practice Physician in Leavenworth, Kansas. Registered with an NPI since 2020.

In the registry since
2020
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

3550 S 4th St Ste 100
Leavenworth, KS 66048-5061
Phone: (913) 680-6200
Fax: (913) 680-6348
Show map & directions

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

Specialties & licences

General Practice Physician (primary) Taxonomy 208D00000X

Record details

NPI number1972119741
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationPrime Healthcare Physician Services - Providence Inc
Authorized official David Dulny — Providence Cfo · (913) 596-4835
NPI enumeratedSeptember 17, 2020
Last updated in NPPESAugust 25, 2025
Certification dateAugust 25, 2025
Mailing address1000 Carondelet Dr, Physician Billing Office, Kansas City, MO 64114

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