Individual provider Active NPI

Holly Ann Stein, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Wichita, KS
National Provider Identifier
1134701394
Registry record updated Jul 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
53-80511-102 Issued in KS
Practice address
250 N Rock Rd Ste 300G
Wichita, KS 67206-2263
Phone
(316) 500-7610
Fax
(316) 661-1523
NPI assigned
Apr 26, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 53-80511-102 KS Primary

Addresses

Primary practice location

250 N Rock Rd Ste 300G
Wichita, KS 67206-2263

Mailing address

2426 N Woodridge Cir
Wichita, KS 67226-8202

Other practice location 1

1507 W 21st St N
Wichita, KS 67203-2449
Phone (316) 221-7310

Other identifiers 1

IdentifierTypeStateIssuer
30004769620001MedicaidKS

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221229000299 KS Practitioner - Nurse Practitioner 0446620827 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
53-80511-102KSMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Medical Group Via Christi, PA CurrentSince Jan 30, 2023 Accepting new patients
Ascension Medical Group Via Christi, PA CurrentSince Jan 30, 2023 Accepting new patients
Journey Mental Health, LLC Psychiatric/Mental Health CurrentSince Feb 1, 2023 Accepting new patients
KVC Hospitals Inc Past Accepting new patients
KVC Hospital Inc Past Accepting new patients
KVC Hospitals Inc Past Accepting new patients
KVC Hospitals Inc Past Accepting new patients

Locations

3311 E Murdock St
Wichita, KS 67208
Phone (316) 689-9107

1515 S Clifton Ave
Ste 300
Wichita, KS 67218
Phone (316) 682-6551

250 N Rock Rd
Ste 300G
Wichita, KS 67206
Phone (316) 500-7610

3600 E Harry St
Wichita, KS 67218
Phone (316) 268-5426

Organizations & group practices 7

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": "1619395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690675200000",
    "number": "1134701394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2426 N WOODRIDGE CIR",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672268202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 N ROCK RD STE 300G",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672062263",
            "telephone_number": "316-500-7610",
            "fax_number": "316-661-1523"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1507 W 21st St N",
            "address_purpose": "LOCATION",
            "city": "Wichita",
            "state": "KS",
            "postal_code": "672032449",
            "country_code": "US",
            "telephone_number": "316-221-7310",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEIN",
        "first_name": "HOLLY",
        "middle_name": "ANN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-26",
        "last_updated": "2023-07-30",
        "certification_date": "2023-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KS",
            "license": "53-80511-102",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30004769620001",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.