Amanda Beth Abasolo, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

5376110091 Issued in KS

Practice address

755 W Lincoln St
Wichita, KS 67213-4527

Phone

(316) 866-2000

Fax

(316) 866-2084

NPI assigned

Aug 20, 2013

Last updated

Nov 27, 2019By 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 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• Signify Health Medical Associates of Kansas LLC

  • Multi-Specialty Clinic/Center
  • Wichita, KS
  • NPI 1780261701
  Medicare reassignment NPD
• Gracemed Health Clinic Inc

  • Federally Qualified Health Center (FQHC)
  • Wichita, KS
  • NPI 1184691693
  Medicare reassignment
• Gracemed Health Clinic, Inc

  dba GraceMed Mother Mary Anne Clinic

  • Federally Qualified Health Center (FQHC)
  • Wichita, KS
  • NPI 1275893224
  NPD (past)
• Gracemed Health Clinic, Inc

  dba GraceMed Jardine Family Clinic

  • Federally Qualified Health Center (FQHC)
  • Wichita, KS
  • NPI 1730575069
  NPD (past)

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

{
    "created_epoch": "1376956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574812800000",
    "number": "1073946455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "426 E QUAIL RIDGE CT",
            "city": "MULVANE",
            "state": "KS",
            "postal_code": "671101136",
            "telephone_number": "316-613-1057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 W LINCOLN ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672134527",
            "telephone_number": "316-866-2000",
            "fax_number": "316-866-2084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABASOLO",
        "first_name": "AMANDA",
        "middle_name": "BETH",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-20",
        "last_updated": "2019-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "5376110091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aalbrecht
• ABA and Mental Health Services LLC
• ABA Up and Up KS LLC
• Abal Homes, Inc. (ABAL Home)
• Alexis Nicole Abasolo, APRN
• Abay Neuroscience Center LLC
• Abay Orthodontics
• Emeline Belen Abay, D.M.D.
• Emily Abay
• Eustaquio O Abay II, M.D.

• Family Nurse Practitioner in Wichita, KS
• Providers in Wichita, KS by specialty
• Family Nurse Practitioner in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2019; 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.