Individual provider Active NPI

Nellie Lynn McCune, MSN, APRN, FNP-C

  • Primary Care Nurse Practitioner
  • Douglass, KS
National Provider Identifier
1275243487
Registry record updated Mar 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
53-81750-041 Issued in KS
Practice address
21276 SW Shumway Rd
Douglass, KS 67039-8257
Phone
(316) 619-5343
NPI assigned
Nov 29, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 13-149076-041 KS
Primary Care Nurse Practitioner 363LP2300X 53-81750-041 KS Primary

Addresses

Primary practice location

21276 SW Shumway Rd
Douglass, KS 67039-8257

Mailing address

21276 SW Shumway Rd
Douglass, KS 67039-8257
Phone (316) 619-5343

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
I20230308000244 KS Practitioner - Nurse Practitioner 6800269192 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mid-Kansas Wound Specialist P aGroup PAC ID 3678562147, 17 clinicians

Practice addresses (Care Compare)

10346 E Stonegate LN
Suite 100
Wichita, KS 67206-2054
Phone (316) 910-0024

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
13-149076-041KSMDRegistered Nurse
53-81750-041KSMDPrimary Care Nurse Practitioner

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": "1669680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680134400000",
    "number": "1275243487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21276 SW SHUMWAY RD",
            "city": "DOUGLASS",
            "state": "KS",
            "postal_code": "670398257",
            "telephone_number": "316-619-5343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21276 SW SHUMWAY RD",
            "city": "DOUGLASS",
            "state": "KS",
            "postal_code": "670398257",
            "telephone_number": "316-619-5343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCUNE",
        "first_name": "NELLIE",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "MSN, APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-29",
        "last_updated": "2023-03-30",
        "certification_date": "2023-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KS",
            "license": "13-149076-041",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "KS",
            "license": "53-81750-041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Douglass, KS

Sources for this page

Verify at the official NPI Registry.