Individual provider Active NPI

Gina Janea Abraham, APRN

  • Family Nurse Practitioner
  • Wichita, KS
National Provider Identifier
1033619085
Registry record updated Nov 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
53-77978-091 Issued in 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
Last updated
Nov 17, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 53-77978-091 KS Primary

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180319002476 KS Practitioner - Nurse Practitioner 8325300916 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
53-77978-091KSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Psychiatric Services, LLC CurrentSince Apr 1, 2020 Accepting new patients
Signify Health Medical Associates of Kansas LLC CurrentSince Jul 10, 2023 Accepting new patients

Locations

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1518739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605571200000",
    "number": "1033619085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 N RIDGE RD STE B",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672126576",
            "telephone_number": "405-544-0265",
            "fax_number": "855-223-1999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 N RIDGE RD STE B",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672126576",
            "telephone_number": "316-616-1055",
            "fax_number": "855-633-0585"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3334 N Grey Meadow Ct",
            "address_purpose": "LOCATION",
            "city": "Wichita",
            "state": "KS",
            "postal_code": "672058716",
            "country_code": "US",
            "telephone_number": "316-992-7900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ABRAHAM",
        "first_name": "GINA",
        "middle_name": "JANEA",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-16",
        "last_updated": "2020-11-17",
        "certification_date": "2020-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "53-77978-091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.