Ennoble Hc Ks III LLC
NPI 1568344471ActiveOrganization· Family Medicine, Geriatric Medicine· Wichita, KS
Family Medicine, Geriatric Medicine in Wichita, Kansas, registered in NPPES in July 2025. The authorized official on file is Mark Bradshaw, MD, Physician. Enrolled in Medicare as part b supplier - clinic/group practice and part b supplier - clinic/group practice.
Overview
| NPI | 1568344471 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jul 22, 2025 |
| Last updated in NPPES | Aug 1, 2025 |
| Certified by provider | Aug 1, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Family Medicine, Geriatric Medicine Primary | 207QG0300X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (KS); Part B Supplier - Clinic/Group Practice (MO) |
|---|
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