Prime Healthcare Physician Services - Providence Inc
NPI 1972119741ActiveOrganization· General Practice· Leavenworth, KS
General Practice in Leavenworth, Kansas, registered in NPPES in September 2020, part of Prime Healthcare Physician Services - Providence Inc. The authorized official on file is David Dulny, Providence Cfo.
Overview
| NPI | 1972119741 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Prime Healthcare Physician Services - Providence Inc |
| NPI issued | Sep 17, 2020 |
| Last updated in NPPES | Aug 25, 2025 |
| Certified by provider | Aug 25, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| General Practice Primary | 208D00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|