Johnna Suzanne Costello, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

53-75854-011 Issued in KS

Practice address

3311 E Murdock St
Wichita, KS 67208-3054

Phone

(316) 689-9107

Fax

(316) 689-9354

NPI assigned

Nov 15, 2012

Last updated

Sep 30, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Johnna Suzanne Wendt Former name

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

Specialty

Nurse Practitioner

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ascension Medical Group Via Christi PAGroup PAC ID 2961314497, 184 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Ascension Medical Group Via Christi, PA

  • Multi-Specialty Clinic/Center
  • Wichita, KS
  • NPI 1063453991
  Medicare reassignment Care Compare group NPD
• Restored Vitality Mobile Wound Care LLC

  • Physician Assistant
  • Overland Park, KS
  • NPI 1073300828

  Family

  Medicare reassignment NPD
• T & J Medical Solutions Corporation

  • Wound Care Registered Nurse
  • Overland Park, KS
  • NPI 1598587537
  Medicare reassignment NPD
• Ascension Medical Group Via Christi, PA

  • Rural Health Clinic/Center
  • Wellington, KS
  • NPI 1538773569
  NPD

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

{
    "created_epoch": "1352937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475193600000",
    "number": "1184968133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8035",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672080035",
            "telephone_number": "316-689-9135",
            "fax_number": "316-689-9667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3311 E MURDOCK ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672083054",
            "telephone_number": "316-689-9107",
            "fax_number": "316-689-9354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTELLO",
        "first_name": "JOHNNA",
        "middle_name": "SUZANNE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-15",
        "last_updated": "2016-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "53-75854-011",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "003719478",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201012490C",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOHNNA",
            "last_name": "WENDT",
            "middle_name": "SUZANNE",
            "credential": "APRN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Abbey Cotter, RN
• Austin T Cotter

• Family Nurse Practitioner in Wichita, KS
• Providers in Wichita, KS by specialty
• Family Nurse Practitioner in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.