Active NPI
Brenda L Trammel, LCP
- Clinical Psychologist
- Wichita, KS
National Provider Identifier
1194763680
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1457
- Practice address
- 6611 E Central Ave Ste C
Wichita, KS 67206-1937 - Phone
- (316) 993-2715
- Fax
- (866) 316-4467
- NPI assigned
- Jun 4, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 1457 | KS | Primary |
Addresses
Primary practice location
6611 E Central Ave Ste C
Wichita, KS 67206-1937
Mailing address
6611 E Central Ave Ste C
Wichita, KS 67206-1937
Phone (316) 993-2715
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 392674 | Other | KS | BLUE CROSS BLUE SHIELD |
| 200430940F | Medicaid | KS |
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: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240325003146 | KS | Practitioner - Mental Health Counselor | 5991010381 | Practice locations: Wichita, KS |
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
6611 E Central Ave
Suite C
Wichita, KS 67206-1937
Phone (316) 648-1157
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1457 | KS | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149379200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727222400000",
"number": "1194763680",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6611 E CENTRAL AVE STE C",
"city": "WICHITA",
"state": "KS",
"postal_code": "672061937",
"telephone_number": "316-993-2715",
"fax_number": "866-316-4467"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6611 E CENTRAL AVE STE C",
"city": "WICHITA",
"state": "KS",
"postal_code": "672061937",
"telephone_number": "316-993-2715",
"fax_number": "866-316-4467"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRAMMEL",
"first_name": "BRENDA",
"middle_name": "L",
"credential": "LCP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-04",
"last_updated": "2024-09-25",
"certification_date": "2024-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "KS",
"license": "1457",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "392674",
"state": "KS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200430940F",
"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 Sep 25, 2024; 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.