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HILLSIDE MEDICAL OFFICE LLC
NPI 1912969486
Family Medicine in Wichita, KS

Active since April 03, 2006CLIA 17D0451899 · Certificate of Compliance
855 N HILLSIDE ST, WICHITA, KS 67214(316) 685-1381 Get Directions Write a Review

NPPES record last updated: June 18, 2009. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Hillside Medical Office Llc NPPES

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

HILLSIDE MEDICAL OFFICE LLC (NPI 1912969486) 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 Certificate of Compliance certificate valid through January 20, 2027 and lists David A Gordon, Manager, as its authorized official.

NPPES Registry Identity

NPI1912969486
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameHILLSIDE MEDICAL OFFICE LLC
Location Address855 N HILLSIDE STWichita, KS 67214-4913
Mailing Address855 N Hillside StWichita, KS 67214-4913 · (316) 685-1381
Phone(316) 685-1381
Organization SubpartNo
Authorized OfficialDavid A GordonManager · (316) 685-1381
Enumeration DateApril 3, 2006
Last NPPES UpdateJune 18, 2009
✔ NPI 1912969486 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
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.
855 N HILLSIDE ST, Wichita, KS 67214
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Other Identifiers 4

Medicare PIN16399KS
Medicaid100087950AKS
Other16399KS · Bc/bs Group Number
Medicare NSC0399360001KS

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 Blue Cross and Blue Shield of Kansas, Inc..Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Hillside Medical Office Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

9

Medicare enrollment records show 9 clinicians reassign Medicare billing to Hillside Medical Office LLC, which bills Medicare for the services they deliver. Of these, 5 practice at this address and 9 within 10 miles. They are listed nearest first.

Clinicians, nearest first (9)

Bonnie Charles Smothers, MD
Family Practice
NPI 1992963763
855 N HILLSIDE ST
Wichita, KS 67214
(316) 685-1381
✔ PECOS✔ Accepts MedicareSame address
Rebecca Foster, DO
Family Practice
NPI 1780970244
855 N HILLSIDE ST
Wichita, KS 67214
(316) 685-1381
✔ PECOS✔ Accepts MedicareSame address
James Logan, MD
Family Practice
NPI 1952363962
855 N HILLSIDE ST
Wichita, KS 67214
(316) 685-1381
✔ PECOS✔ Accepts MedicareSame address
Jason Nugent, MD
Family Practice
NPI 1730334475
855 N HILLSIDE ST
Wichita, KS 67214
(316) 685-1381
✔ PECOS✔ Accepts MedicareSame address
Donna Logan, MD
Family Practice
NPI 1083676084
855 N HILLSIDE ST
Wichita, KS 67214
(316) 685-1381
✔ PECOS✔ Accepts MedicareSame address
Stacy Ignowski
General Practice
NPI 1992363311
1010 N KANSAS ST
Wichita, KS 67214
(316) 858-3460
✔ PECOS✔ Accepts Medicare0.9 mi
Bonnie Tibbe, MD
Family Practice
NPI 1851737217
707 N EMPORIA ST
Wichita, KS 67214
(316) 858-3460
✔ PECOS✔ Accepts Medicare1.9 mi
Joshua Tibbe, MD
Family Practice
NPI 1124347083
5000 S CLIFTON AVE STE 200
Wichita, KS 67216
(316) 866-2000
✔ PECOS✔ Accepts Medicare6.7 mi
Nathan Norris, MD
Family Practice
NPI 1396184420
7107 S MERIDIAN ST
Haysville, KS 67060
(316) 858-8580
✔ PECOS10.0 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 of Compliance 17D0451899

Hillside Medical Office · Wichita, KS
Active · expires Jan 20, 2027
CLIA Number17D0451899
Laboratory TypePhysician Office
Certificate Effective DateJanuary 21, 2025
Certificate Expiration DateJanuary 20, 2027
Laboratory DirectorFarah L. Erickson
Laboratory Phone(316) 685-1381
Laboratory LocationHillside Medical Office855 N Hillside, Wichita, KS 67214
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

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 Hillside Medical Office LLC's NPI number?

The NPI number for Hillside Medical Office LLC is 1912969486. It was assigned to this organization in the NPPES registry on April 3, 2006.

Where is Hillside Medical Office LLC located?

Hillside Medical Office LLC is located at 855 N Hillside St, Wichita, KS 67214. The listed phone number is (316) 685-1381.

What is Hillside Medical Office LLC's specialty?

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

Is Hillside Medical Office LLC enrolled in Medicare?

Yes. Hillside Medical Office LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Hillside Medical Office LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 9 clinicians in 2 Medicare specialties reassign their Medicare billing to Hillside Medical Office LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Family Practice (8) and General Practice (1). Of these, 5 practice at this address and 9 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Hillside Medical Office LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 17D0451899) is associated with this NPI, valid through January 20, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Hillside Medical Office LLC accept?

Health plans from Blue Cross and Blue Shield of Kansas, Inc. list Hillside Medical Office LLC 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 Hillside Medical Office LLC was last updated on June 18, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.