Individual provider Active NPI

Autumn Lowen, APRN

  • Nurse Practitioner
  • Wichita, KS
National Provider Identifier
1225208952
Registry record updated Feb 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
46149 Issued in KS
Practice address
530 N Ridge Rd Ste B
Wichita, KS 67212-6576
Phone
(316) 616-1055
Fax
(855) 633-0585
NPI assigned
Mar 10, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 46149 KS Primary

Addresses

Primary practice location

530 N Ridge Rd Ste B
Wichita, KS 67212-6576

Mailing address

PO Box 929
Chickasha, OK 73023-0929
Phone (405) 896-8058

Other identifiers 4

IdentifierTypeStateIssuer
100299870 BMedicaidKS
100299870BMedicaidKS
100299870MedicaidKS
1225208952OtherKSNPI

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
I20090223000037 KS Practitioner - Nurse Practitioner 1153486378 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Geriatric Primary Care PAGroup PAC ID 2466796024, 16 clinicians

Practice addresses (Care Compare)

12500 W 137TH St
Overland Park, KS 66221-4129
Phone (913) 730-3700

Hospital & facility affiliations

  • Specialized Home Care Home health agency, Wichita, KS, CCN 178111
  • Interim Healthcare of Wichita Home health agency, Wichita, KS, CCN 177090

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
46149KSMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hutchinson Regional Medical Center, Inc. CurrentSince May 30, 2015 Accepting new patients
Hutchinson Regional Medical Center, Inc. CurrentSince May 30, 2015 Accepting new patients

Locations

1701 E 23rd Ave
Hutchinson, KS 67502
Phone (620) 665-2117

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 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": "1205107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581984000000",
    "number": "1225208952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 929",
            "city": "CHICKASHA",
            "state": "OK",
            "postal_code": "730230929",
            "telephone_number": "405-896-8058",
            "fax_number": "855-223-1999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 N RIDGE RD STE B",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672126576",
            "telephone_number": "316-616-1055",
            "fax_number": "855-633-0585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOWEN",
        "first_name": "AUTUMN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-10",
        "last_updated": "2020-02-18",
        "certification_date": "2020-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KS",
            "license": "46149",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100299870 B",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100299870B",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100299870",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1225208952",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.