Active NPI
Aimee Marie Wyant, APRN
- Nurse Practitioner
- Great Bend, KS
National Provider Identifier
1073238317
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 81459
- Practice address
- 3515 Broadway Ave
Great Bend, KS 67530-3633 - Phone
- (620) 792-2511
- Fax
- (620) 786-6262
- NPI assigned
- Oct 10, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 81459 | KS | Primary |
Addresses
Primary practice location
3515 Broadway Ave
Great Bend, KS 67530-3633
Mailing address
3515 Broadway Ave
Great Bend, KS 67530-3633
Phone (620) 792-2511
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230331002669 | KS | Order and Referring Only - Nurse Practitioner | 1850766023 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 81459 | KS | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1665360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1679356800000",
"number": "1073238317",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3515 BROADWAY AVE",
"city": "GREAT BEND",
"state": "KS",
"postal_code": "675303633",
"telephone_number": "620-792-2511",
"fax_number": "620-786-6262"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3515 BROADWAY AVE",
"city": "GREAT BEND",
"state": "KS",
"postal_code": "675303633",
"telephone_number": "620-792-2511",
"fax_number": "620-786-6262"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WYANT",
"first_name": "AIMEE",
"middle_name": "MARIE",
"credential": "APRN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-10-10",
"last_updated": "2023-03-21",
"certification_date": "2023-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "KS",
"license": "81459",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Great Bend, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2023; 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.