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SPECTRUM FAMILY MEDICAL CLINIC, PA
NPI 1912963067
Family Medicine in Wichita, KS

Active since April 25, 2006CLIA 17D0994058 · Microscopy
2020 N TYLER, STE 114, WICHITA, KS 67212(316) 462-0460(316) 462-0465 Get Directions Write a Review

NPPES record last updated: October 5, 2017. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Spectrum Family Medical Clinic, Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SPECTRUM FAMILY MEDICAL CLINIC, PA (NPI 1912963067) is a healthcare organization registered as a family medicine in Wichita, Kansas and active in the NPI registry since April 2006. The organization holds a CLIA Microscopy certificate valid through December 2, 2027 and lists Phaedra M Mann, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1912963067
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameSPECTRUM FAMILY MEDICAL CLINIC, PA
Location Address2020 N TYLER, STE 114Wichita, KS 67212-4916
Mailing Address2020 N Tyler, Ste 114Wichita, KS 67212-4916
Phone(316) 462-0460
Fax(316) 462-0465
Organization SubpartNo
Authorized OfficialPhaedra M MannOffice Manager · (316) 462-0460
Enumeration DateApril 25, 2006
Last NPPES UpdateOctober 5, 2017
✔ NPI 1912963067 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in KS · 0422366
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
2020 N TYLER, Wichita, KS 67212
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Other Identifiers 3

Medicare UPINX61004KS
Medicare ID-Type Unspecified110666KS
Medicaid100112800CKS

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter from Sunflower Health Plan, Ambetter Health and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 17D0994058

Spectrum Family Medical Clinic · Wichita, KS
Active · expires Dec 2, 2027
CLIA Number17D0994058
Laboratory TypePhysician Office
Certificate Effective DateDecember 3, 2025
Certificate Expiration DateDecember 2, 2027
Laboratory DirectorJoseph Sack
Laboratory Phone(316) 462-0460
Laboratory LocationSpectrum Family Medical Clinic2020 N Tyler Rd, Ste 114, Wichita, KS 67212
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Spectrum Family Medical Clinic, PA's NPI number?

The NPI number for Spectrum Family Medical Clinic, PA is 1912963067. It was assigned to this organization in the NPPES registry on April 25, 2006.

Where is Spectrum Family Medical Clinic, PA located?

Spectrum Family Medical Clinic, PA is located at 2020 N Tyler Ste 114, Wichita, KS 67212. The listed phone number is (316) 462-0460.

What is Spectrum Family Medical Clinic, PA's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Spectrum Family Medical Clinic, PA hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 17D0994058) is associated with this NPI, valid through December 2, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Spectrum Family Medical Clinic, PA accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Home State Health, Ambetter from Sunflower Health Plan and Ambetter of Oklahoma and 1 other insurer list Spectrum Family Medical Clinic, PA as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Spectrum Family Medical Clinic, PA was last updated on October 5, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.