Sally Ann Carmitchel, APRN
Individual provider Active NPI Family Nurse Practitioner · Osawatomie, KS
NPI 1164028015 · NPPES record last updated Jan 27, 2025
Key facts
- NPI
- 1164028015
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 53-79790-072 (KS)
- Practice address
- 500 State Hospital Dr
Osawatomie, KS 66064-1813 - Phone
- (913) 755-7000
- Fax
- (913) 755-7408
- NPI assigned
- Dec 7, 2020
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Osawatomie State Hospital
Practice addresses (Care Compare)
500 State Hospital Dr
Osawatomie, KS 66064-1813
Phone (913) 755-7073
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210226000259 | KS | Practitioner - Nurse Practitioner | 6608281522 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 53-79790-072 | KS | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Osawatomie State Hospital | Current |
Accepting new patients | |
| State of Kansas | Past | Accepting new patients |
Locations
500 State Hospital Dr
Osawatomie, KS 66064
Phone (913) 755-7000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 53-79790-072 | KS | Yes |
Addresses
Primary practice location
500 State Hospital Dr
Osawatomie, KS 66064-1813
Mailing address
16955 Dwyer Rd
Basehor, KS 66007-7329
Phone (913) 660-8009
Other providers in Osawatomie, KS
- Nicholas Bruzzese
- Kari L Burchett
- James Burnett
- Emily Busenitz
- Callie M Callahan
- Centered Within - Family Chiropractic
- Luminita Ciumpavu
- Sara Jean Cobine
- Haleigh Amber Coburn
- Cook Chiropractic, LLC
All providers in Osawatomie, KS · Family Nurse Practitioner in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 27, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.