Individual provider Active NPI

Hannah Elizabeth Nettelblad, MD

  • Student in an Organized Health Care Education/Training Program
  • Kansas City, KS
National Provider Identifier
1083301139
Registry record updated Apr 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
3901 Rainbow Blvd
Kansas City, KS 66160-8500
Phone
(913) 588-6245
NPI assigned
Apr 19, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X KS Primary

Addresses

Primary practice location

3901 Rainbow Blvd
Kansas City, KS 66160-8500

Mailing address

3901 Rainbow Blvd # Ms 2028
Kansas City, KS 66160-8500
Phone (913) 588-6245

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230629001001 KS Order and Referring Only - Obstetrics/GynecologyPractitioner - Obstetrics/Gynecology 4789043464

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1681862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681862400000",
    "number": "1083301139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 RAINBOW BLVD # MS 2028",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661608500",
            "telephone_number": "913-588-6245",
            "fax_number": "913-588-0888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 RAINBOW BLVD",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661608500",
            "telephone_number": "913-588-6245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NETTELBLAD",
        "first_name": "HANNAH",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-19",
        "last_updated": "2023-04-19",
        "certification_date": "2023-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "KS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, KS

Sources for this page

Verify at the official NPI Registry.