NPIMap

Individual provider Active NPI

Danielle Nicole Bedore, PA-C

  • Physician Assistant
  • Manhattan, KS
National Provider Identifier
1124363387
Registry record updated May 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
15-02336 Issued in KS
Practice address
1823 College Ave
Manhattan, KS 66502-3381
Phone
(785) 323-6300
Fax
(785) 587-5486
NPI assigned
Nov 29, 2012
Last updated
May 8, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 15-02336 KS Primary

Addresses

Primary practice location

1823 College Ave
Manhattan, KS 66502-3381

Mailing address

1823 College Ave
Manhattan, KS 66502-3381
Phone (785) 323-6300

Other names 1

  • Danielle Nicole Butler Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200616001839 KS Practitioner - Physician Assistant 9830336866 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1823 College Ave
Manhattan, KS 66502-3381
Phone (785) 776-3322

930 Hayes Dr
Suite B
Manhattan, KS 66502-5721
Phone (785) 565-0016

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2219OKMDMental Health Counselor
15-02336KSMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Via Christi Hospital Manhattan, Inc. Physician Assistant Current Accepting new patients
Stormont Vail Health Flint Hills LLC Current Accepting new patients
Ascension Via Christi Hospital Manhattan, Inc. CurrentSince Aug 1, 2022 Accepting new patients
Ascension Via Christi Hospital Manhattan, Inc. CurrentSince Aug 1, 2022 Accepting new patients
Wamego Hospital Association CurrentSince Jul 10, 2024 Accepting new patients

Locations

1110 Saint Marys Rd
Ste 201
Junction City, KS 66441
Phone (785) 762-4575

1110 Saint Marys Rd
Ste 308
Junction City, KS 66441

1823 College Ave
Manhattan, KS 66502
Phone (785) 539-1704

711 Genn Dr
Wamego, KS 66547
Phone (785) 456-2295

Interoperability endpoints

  • Direct secure messaging: danielle.bedore.1@20807.direct.athenahealth.com

Organizations & group practices 6

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1354147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715126400000",
    "number": "1124363387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1823 COLLEGE AVE",
            "city": "MANHATTAN",
            "state": "KS",
            "postal_code": "665023381",
            "telephone_number": "785-323-6300",
            "fax_number": "785-587-5486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1823 COLLEGE AVE",
            "city": "MANHATTAN",
            "state": "KS",
            "postal_code": "665023381",
            "telephone_number": "785-323-6300",
            "fax_number": "785-587-5486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEDORE",
        "first_name": "DANIELLE",
        "middle_name": "NICOLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-29",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KS",
            "license": "15-02336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANIELLE",
            "last_name": "BUTLER",
            "middle_name": "NICOLE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Manhattan, KS

Sources for this page

Verify at the official NPI Registry.