Individual provider Active NPI

Thu Kester-Phan

  • Family Nurse Practitioner
  • Wichita, KS
National Provider Identifier
1215788674
Registry record updated Apr 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
53-83051-092 Issued in KS
Practice address
1961 N Founders Cir
Wichita, KS 67206-3548
Phone
(316) 469-7701
NPI assigned
Apr 1, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2024

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 53-83051-092 KS Primary

Addresses

Primary practice location

1961 N Founders Cir
Wichita, KS 67206-3548

Mailing address

1961 N Founders Cir
Wichita, KS 67206-3548

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
I20240722001738 KS Practitioner - Nurse Practitioner 1153867528 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ascension Medical Group Via Christi PAGroup PAC ID 2961314497, 184 clinicians
Heartland Interventional Pain and Spine, LLCGroup PAC ID 3870069487, 3 clinicians

Practice addresses (Care Compare)

1947 N Founders Cir
Via Christi Clinic PA
Wichita, KS 67206-3548
Phone (316) 613-4640

2450 N Woodlawn Blvd
Wichita, KS 67220-3902
Phone (405) 227-7479

Hospital & facility affiliations

  • Ascension Via Christi Hospitals Wichita, Inc. Hospital, Wichita, KS, CCN 170122
  • Ascension Via Christi Rehabilitation Hospital, Inc Inpatient rehabilitation facility, Wichita, KS, CCN 173028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
53-83051-092KSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Medical Group Via Christi, PA CurrentSince Jul 1, 2024 Accepting new patients
Ascension Medical Group Via Christi, PA CurrentSince Jul 1, 2024 Accepting new patients
Ascension Medical Group Via Christi, PA Past Accepting new patients

Locations

1947 N Founders Cir
Wichita, KS 67206
Phone (316) 613-4640

3311 E Murdock St
Wichita, KS 67208
Phone (316) 689-9107

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1711929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711929600000",
    "number": "1215788674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1961 N FOUNDERS CIR",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672063548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1961 N FOUNDERS CIR",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672063548",
            "telephone_number": "316-469-7701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KESTER-PHAN",
        "first_name": "THU",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-01",
        "last_updated": "2024-04-01",
        "certification_date": "2024-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "53-83051-092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.