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PRIME HEALTHCARE PHYSICIAN SERVICES - PROVIDENCE INC
NPI 1972119741
General Practice in Leavenworth, KS

Active since September 17, 2020
3550 S 4TH ST STE 100, LEAVENWORTH, KS 66048(913) 680-6200(913) 680-6348 Get Directions Write a Review

NPPES record last updated: August 25, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Feb 15, 2021, Sep 28, 2020, Sep 17, 2020 (3 updates tracked since 2020).

About Prime Healthcare Physician Services - Providence Inc NPPES

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

PRIME HEALTHCARE PHYSICIAN SERVICES - PROVIDENCE INC (NPI 1972119741) is a healthcare organization registered as a general practice in Leavenworth, Kansas and active in the NPI registry since September 2020. The organization lists David Dulny, Providence Cfo, as its authorized official.

NPPES Registry Identity

NPI1972119741
Entity TypeOrganization
Primary Taxonomy208D00000X
Legal Business NamePRIME HEALTHCARE PHYSICIAN SERVICES - PROVIDENCE INC
Location Address3550 S 4TH ST STE 100Leavenworth, KS 66048-5061
Mailing Address1000 Carondelet Dr, Physician Billing OfficeKansas City, MO 64114 · (816) 943-2283 · Fax (816) 943-5762
Phone(913) 680-6200
Fax(913) 680-6348
Organization SubpartYes
Authorized OfficialDavid DulnyProvidence Cfo · (913) 596-4835
Enumeration DateSeptember 17, 2020
Last NPPES UpdateAugust 25, 20253 updates tracked since enumeration
NPPES CertifiedAugust 25, 2025
✔ NPI 1972119741 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
Definition

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

3550 S 4TH ST STE 100, Leavenworth, KS 66048
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-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 ›

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 Prime Healthcare Physician Services - Providence Inc's NPI number?

The NPI number for Prime Healthcare Physician Services - Providence Inc is 1972119741. It was assigned to this organization in the NPPES registry on September 17, 2020.

Where is Prime Healthcare Physician Services - Providence Inc located?

Prime Healthcare Physician Services - Providence Inc is located at 3550 S 4th St Ste 100, Leavenworth, KS 66048. The listed phone number is (913) 680-6200.

What is Prime Healthcare Physician Services - Providence Inc's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

What insurance does Prime Healthcare Physician Services - Providence Inc 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 2 other insurers list Prime Healthcare Physician Services - Providence Inc 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 Prime Healthcare Physician Services - Providence Inc was last updated on August 25, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.