Individual provider Active NPI

Sally Ann Carmitchel, APRN

  • Family Nurse Practitioner
  • Osawatomie, KS
National Provider Identifier
1164028015
Registry record updated Jan 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
53-79790-072 Issued in KS
Practice address
500 State Hospital Dr
Osawatomie, KS 66064-1813
Phone
(913) 755-7000
Fax
(913) 755-7408
NPI assigned
Dec 7, 2020
Last updated
Jan 27, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 53-79790-072 KS Primary

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

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
I20210226000259 KS Practitioner - Nurse Practitioner 6608281522 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osawatomie State HospitalGroup PAC ID 5698053866, 11 clinicians

Practice addresses (Care Compare)

500 State Hospital Dr
Osawatomie, KS 66064-1813
Phone (913) 755-7073

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
53-79790-072KSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Osawatomie State Hospital CurrentSince Jan 11, 2021 Accepting new patients
State of Kansas Past Accepting new patients

Locations

500 State Hospital Dr
Osawatomie, KS 66064
Phone (913) 755-7000

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1607299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737936000000",
    "number": "1164028015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16955 DWYER RD",
            "city": "BASEHOR",
            "state": "KS",
            "postal_code": "660077329",
            "telephone_number": "913-660-8009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 STATE HOSPITAL DR",
            "city": "OSAWATOMIE",
            "state": "KS",
            "postal_code": "660641813",
            "telephone_number": "913-755-7000",
            "fax_number": "913-755-7408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARMITCHEL",
        "first_name": "SALLY",
        "middle_name": "ANN",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-07",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "53-79790-072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Osawatomie, KS

Sources for this page

Verify at the official NPI Registry.