Individual provider Active NPI

Kenneth CHI Ndikum, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Topeka, KS
National Provider Identifier
1164135679
Registry record updated Jan 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
81501 Issued in KS
Practice address
3360 SW Harrison St
Topeka, KS 66611-2492
Phone
(785) 266-4100
NPI assigned
Dec 29, 2022
Last updated
Jan 18, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 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 81501 KS Primary

Addresses

Primary practice location

3360 SW Harrison St
Topeka, KS 66611-2492

Mailing address

3360 SW Harrison St
Topeka, KS 66611-2492
Phone (785) 266-4100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
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
I20251112001548 AK Practitioner - Nurse Practitioner 1850821786 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3116 E Long Beach Cir
Wasilla, AK 99654-6065

4119 Mountain View Dr
Anchorage, AK 99508-1546

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
81501KSMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain View Community Mental Health and Recovery Center LLC Psychiatric/Mental Health CurrentSince Oct 1, 2025 Accepting new patients
Pacck Health Care Inc Psychiatric/Mental Health CurrentSince Dec 22, 2024 Accepting new patients
Topeka Treatment Center, LLC CurrentSince Apr 16, 2023 Accepting new patients

Locations

4119 Mountain View Dr
Anchorage, AK 99508
Phone (907) 222-4851

2611 SW 17th St
Topeka, KS 66604
Phone (785) 250-5002

3360 SW Harrison St
Topeka, KS 66611
Phone (785) 266-4100

Organizations & group practices 3

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": "1672272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674000000000",
    "number": "1164135679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3360 SW HARRISON ST",
            "city": "TOPEKA",
            "state": "KS",
            "postal_code": "666112492",
            "telephone_number": "785-266-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3360 SW HARRISON ST",
            "city": "TOPEKA",
            "state": "KS",
            "postal_code": "666112492",
            "telephone_number": "785-266-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NDIKUM",
        "first_name": "KENNETH",
        "middle_name": "CHI",
        "name_prefix": "Mr.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-12-29",
        "last_updated": "2023-01-18",
        "certification_date": "2023-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KS",
            "license": "81501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Topeka, KS

Sources for this page

Verify at the official NPI Registry.