Organization
LITTLE CLINIC OF KANSAS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS SHELLY (VP & GENERAL MANAGER)
(615) 425-4200
Entity
Organization
Contact information
Practice address
7707 E CENTRAL AVE, WICHITA, KS 67206-2100
(316) 651-2500
(316) 651-2775
Mailing address
PO BOX 932958, CLEVELAND, OH 44193-0028
(615) 425-4200
(615) 425-4201
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
—
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201153690A
—
KS
05
—
30003892670001
—
KS
05
—
30003892670003
—
KS
05
—
30003892670004
—
KS
05
—
30003892670005
—
KS
05
—
30003892670006
—
KS
05
—
30003892670007
—
KS
05
—
30003892670008
—
KS
05
—
30003892670009
—
KS
Enumeration date
04/02/2015
Last updated
10/22/2025
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