Individual provider Active NPI

Noelle Ghram, OTR/L

  • Occupational Therapist
  • Wichita, KS
National Provider Identifier
1245077254
Registry record updated Jul 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
17-01964 Issued in KS
Practice address
10346 E Stonegate LN
Wichita, KS 67206-2053
Phone
(316) 910-0024
Fax
(316) 910-0023
NPI assigned
Jul 9, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 17-01964 KS Primary

Addresses

Primary practice location

10346 E Stonegate LN
Wichita, KS 67206-2053

Mailing address

208 Bent Tree CT
Andover, KS 67002-9251
Phone (417) 529-5955

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240801001183 KS Practitioner - Occupational Therapist in Private Practice 0840737409 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
17-01964KSMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-Kansas Wound Specialist P a CurrentSince Jul 1, 2024 Accepting new patients

Locations

10346 E Stonegate Ln
Ste 100
Wichita, KS 67206
Phone (316) 871-0995

550 N Hillside St
Wichita, KS 67214
Phone (316) 688-2239

10346 E Stonegate Ln
Wichita, KS 67206
Phone (316) 910-0024

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1720483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720483200000",
    "number": "1245077254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 BENT TREE CT",
            "city": "ANDOVER",
            "state": "KS",
            "postal_code": "670029251",
            "telephone_number": "417-529-5955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10346 E STONEGATE LN",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672062053",
            "telephone_number": "316-910-0024",
            "fax_number": "316-910-0023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHRAM",
        "first_name": "NOELLE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-09",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "KS",
            "license": "17-01964",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jul 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.