Individual provider Active NPI

Elizabeth Evans, APRN

  • Nurse Practitioner
  • Wichita, KS
National Provider Identifier
1083918643
Registry record updated Nov 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
TEP-142175 Issued in KS
Practice address
1131 S Clifton Ave
Wichita, KS 67218-2955
Phone
(316) 866-2000
Fax
(316) 866-2084
NPI assigned
Dec 22, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X TEP-142175 KS Primary

Addresses

Primary practice location

1131 S Clifton Ave
Wichita, KS 67218-2955

Mailing address

1131 S Clifton
Suite B
Wichita, KS 67218
Phone (316) 462-1040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS, CT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20110315000340 KS Practitioner - Nurse Practitioner 8820270630 Reassigns benefits to 2 organizations
I20211115002283 CT Practitioner - Nurse Practitioner 8820270630 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
TEP-142175KSMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Inpatient Consultants of Kansas PA CurrentSince Feb 3, 2014 Accepting new patients
Inpatient Consultants of Kansas PA CurrentSince Feb 3, 2014 Accepting new patients
Urgent Care Medical Center LLC CurrentSince Dec 1, 2021 Accepting new patients
Integrity Medicine LLC PastSince Oct 1, 2004 Accepting new patients

Locations

105 West Rd
Ellington, CT 06029
Phone (860) 454-0678

45 S Main St
Unionville, CT 06085
Phone (860) 454-0678

10500 Quivira Rd
Shawnee Mission, KS 66215
Phone (913) 227-0565

9100 W 74th St
Shawnee Msn, KS 66204
Phone (913) 632-2230

1131 S Clifton Ave
Ste B
Wichita, KS 67218
Phone (316) 462-1040

1122 N Topeka St
Wichita, KS 67214
Phone (316) 263-7455

1505 Memorial Dr
Chicopee, MA 01020
Phone (413) 331-4336

430 Cooley St
Springfield, MA 01128
Phone (413) 295-4144

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1292976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574380800000",
    "number": "1083918643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1131 S CLIFTON",
            "address_2": "SUITE B",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "67218",
            "telephone_number": "316-462-1040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1131 S CLIFTON AVE",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672182955",
            "telephone_number": "316-866-2000",
            "fax_number": "316-866-2084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "ELIZABETH",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-22",
        "last_updated": "2019-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KS",
            "license": "TEP-142175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.