Individual provider Active NPI

Jean T Dukich, CNS-BC

  • Clinical Nurse Specialist
  • Wichita, KS
National Provider Identifier
1154639185
Registry record updated Aug 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Nurse SpecialistTaxonomy code 364S00000X
License
53-74439 Issued in KS
Practice address
848 N Saint Francis St
Suite 1900
Wichita, KS 67214-3841
Phone
(316) 268-5881
Fax
(316) 268-8159
NPI assigned
Sep 24, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Nurse Specialist 364S00000X 53-74439 KS Primary
Registered Nurse 163W00000X 34090 KS

Addresses

Primary practice location

848 N Saint Francis St
Suite 1900
Wichita, KS 67214-3841

Mailing address

PO Box 1897
Wichita, KS 67201-1897
Phone (316) 268-8131

Other identifiers 1

IdentifierTypeStateIssuer
100254720BMedicaidKS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34090KSMDRegistered Nurse
53-74439KSMDClinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Via Christi Hospitals Wichita Inc. Past Accepting new patients

Organizations & group practices 1

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": "1285286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408924800000",
    "number": "1154639185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1897",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672011897",
            "telephone_number": "316-268-8131",
            "fax_number": "316-291-4788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "848 N SAINT FRANCIS ST",
            "address_2": "SUITE 1900",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672143841",
            "telephone_number": "316-268-5881",
            "fax_number": "316-268-8159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUKICH",
        "first_name": "JEAN",
        "middle_name": "T",
        "name_prefix": "Ms.",
        "credential": "CNS-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-24",
        "last_updated": "2014-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "KS",
            "license": "53-74439",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KS",
            "license": "34090",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100254720B",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.