KSP HEALTH - ARIZONA LLC – Pediatrics Physician, NPI 1104607142

KSP HEALTH - ARIZONA LLC is a healthcare provider. based in Wichita, Kansas. specializing in Pediatrics Physician. The NPI Number for KSP HEALTH - ARIZONA LLC is 1104607142

Main info

Organization
Name
KSP HEALTH - ARIZONA LLC
NPI
1104607142
Phone
(234) 260-6212
Address
6446 E CENTRAL AVE STE 183
Authorized Official
MUTHUKUMAR VELLAICHAMY OWNER MD
Enumeration Date
6 October 2023
Last Update Date
2 January 2024
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience29
Completeness80
Years active:2State licenses:0Digital endpointsUpdated within 12 months

Provider Addresses for KSP HEALTH - ARIZONA LLC

  • 6446 E CENTRAL AVE STE 183

    WICHITA, KS 672061923

    Phone: (234) 260-6212

    Type: Mailing

  • 1846 E INNOVATION PARK DR STE 100

    ORO VALLEY, AZ 857551963

    Phone: (234) 260-6212

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

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Medicare Enrollment & Revalidation

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No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

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No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 67206)

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Reviews

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Frequently asked questions

Can I cross-check KSP HEALTH - ARIZONA LLC using NPI 1104607142?
NPI 1104607142 belongs to KSP HEALTH - ARIZONA LLC; compare other details if you need extra assurance.
Is KSP HEALTH - ARIZONA LLC shown as active in public data?
Registry records indicate KSP HEALTH - ARIZONA LLC maintains an active NPI.
What clinical focus is listed for KSP HEALTH - ARIZONA LLC?
At a glance, KSP HEALTH - ARIZONA LLC is tied to Pediatrics Physician. Clinical services aligned with this taxonomy classification.
What practice footprint exists for KSP HEALTH - ARIZONA LLC?
Travel planning: use Wichita, Kansas as the reference point for KSP HEALTH - ARIZONA LLC, then confirm.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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