Gina Janea Abraham, APRN
Individual provider Active NPI Family Nurse Practitioner · Wichita, KS
NPI 1033619085 · NPPES record last updated Nov 17, 2020
Key facts
- NPI
- 1033619085
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 53-77978-091 (KS)
- Practice address
- 530 N Ridge Rd Ste B
Wichita, KS 67212-6576 - Phone
- (316) 616-1055
- Fax
- (855) 633-0585
- NPI assigned
- Feb 16, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180319002476 | KS | Practitioner - Nurse Practitioner | 8325300916 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 53-77978-091 | KS | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Signify Health Medical Associates of Kansas LLC | Current |
Accepting new patients | |
| Midwest Psychiatric Services, LLC | Current |
Accepting new patients |
Locations
4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 53-77978-091 | KS | Yes |
Addresses
Primary practice location
530 N Ridge Rd Ste B
Wichita, KS 67212-6576
Mailing address
530 N Ridge Rd Ste B
Wichita, KS 67212-6576
Phone (405) 544-0265
Other practice location 1
3334 N Grey Meadow Ct
Wichita, KS 67205-8716
Phone (316) 992-7900
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 201197560A | Medicaid | KS |
Other providers in Wichita, KS
- Dory Abou Jaoude
- Cynthia Abou Mayla Hayek
- Hadi Abou Zeid
- About You Palliative Care & Hospice, LLC
- Benjamin Elwyn Abraham
- Ike Abrams
- Elba Abreu
- Absolute Diagnostics, LLC
- Absolute Home Health Care Inc
- Raid Abu-Awwad
All providers in Wichita, KS · Family Nurse Practitioner in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 17, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.