Mary Beth Hartley, APRN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

45384 Issued in KS

Practice address

1400 W 4TH St
Coffeyville, KS 67337-3306

Phone

(620) 688-6566

Fax

(620) 688-6577

NPI assigned

Jul 7, 2005

Last updated

Nov 30, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Galichia Medical Group, P.a.

  • Cardiovascular Disease Physician
  • Wichita, KS
  • NPI 1447238621
  NPD (past)
• Pawnee Valley Community Hospital Inc

  dba Pawnee Valley Community Hospital Family Medicine

  • General Practice Physician
  • Larned, KS
  • NPI 1912310822
  NPD (past)
• Integris Baptist Regional Health Center

  dba Integris Baptist Regional Health Center ER Physician

  • Emergency Care Clinic/Center
  • Miami, OK
  • NPI 1811952963
  NPD (past)

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480464000000",
    "number": "1073510764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 505252",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631505262",
            "telephone_number": "620-688-6566",
            "fax_number": "620-688-6577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 W 4TH ST",
            "city": "COFFEYVILLE",
            "state": "KS",
            "postal_code": "673373306",
            "telephone_number": "620-688-6566",
            "fax_number": "620-688-6577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTLEY",
        "first_name": "MARY BETH",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-07",
        "last_updated": "2016-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KS",
            "license": "45384",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "121186",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100446860G",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100446860D",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "110385030",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Heath Haffener, D.C.
• Stephen Mark Haley, RPH
• Denise Hall, DPH
• Chan S Han, MD
• Shelley Rene Harper
• William Haskell Hay II, PHARMD
• Haleigh Haynes
• Health Care Associates of Southeast Kansas, LLC
• Health Management of Kansas, Inc. (Windsor Place At-Home Care, LLC.)
• Health Management of Kansas, Inc. (Windsor Place, LLC.)

• Nurse Practitioner in Coffeyville, KS
• Providers in Coffeyville, KS by specialty
• Nurse Practitioner in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.