Nisha Brunson, DO

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

94-11724 Issued in KS

Practice address

1010 N Kansas St
Wichita, KS 67214-3199

Phone

(316) 293-2635

NPI assigned

Apr 19, 2021

Last updated

Jun 6, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

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.

• University of Kansas School of Medicine Wichita Medical Practice Assoc

  • Internal Medicine Physician
  • Wichita, KS
  • NPI 1639143712
  NPD

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

{
    "created_epoch": "1618790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717632000000",
    "number": "1073194304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 N KANSAS ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672143199",
            "telephone_number": "316-293-2635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 N KANSAS ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672143199",
            "telephone_number": "316-293-2635"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1005 Dr D. B. Todd Jr. Blvd.",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372083720",
            "country_code": "US",
            "telephone_number": "615-327-6350",
            "fax_number": "615-327-6260",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRUNSON",
        "first_name": "NISHA",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-19",
        "last_updated": "2024-06-06",
        "certification_date": "2024-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "KS",
            "license": "94-11724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gerard S Brungardt, MD
• Janet L Brungardt, M.D.
• Christopher N Brunner, MD
• Deserae Bruns
• Christopher William Brunson, LCPC
• Allison Kay Bruntz, OTR
• Lindsay D Bryan
• Martha Jean Bryan, LCP
• Alison Leigh Bryant, IBCLC
• Caryn Bryant, M.D.

• Child & Adolescent Psychiatry Physician in Wichita, KS
• Providers in Wichita, KS by specialty
• Child & Adolescent Psychiatry Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.