Individual provider Active NPI

Kristin Lee Bliss, APRN, FNP-BC

  • Family Nurse Practitioner
  • Wichita, KS
National Provider Identifier
1275356180
Registry record updated Nov 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
53-83770-112 Issued in KS
Practice address
2707 E 21St St N
Wichita, KS 67214-2249
Phone
(316) 691-0249
NPI assigned
Nov 7, 2024
Last updated
Nov 7, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 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 53-83770-112 KS Primary

Addresses

Primary practice location

2707 E 21St St N
Wichita, KS 67214-2249

Mailing address

2707 E 21St St N
Wichita, KS 67214-2249
Phone (316) 691-0249

Other identifiers 1

IdentifierTypeStateIssuer
1634839OtherCAQH

Other names 1

  • Kristin Lee McEntire Former name

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
I20241217002046 KS Practitioner - Nurse Practitioner 0143757088 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthcore Clinic IncGroup PAC ID 9739092131, 18 clinicians

Practice addresses (Care Compare)

2707 E 21St St N
Wichita, KS 67214-2249
Phone (316) 691-0249

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
53-83770-112KSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Healthcore Clinic Inc CurrentSince Dec 1, 2024 Accepting new patients

Locations

2707 E 21st St N
Wichita, KS 67214
Phone (316) 691-0249

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1730937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730937600000",
    "number": "1275356180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2707 E 21ST ST N",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672142249",
            "telephone_number": "316-691-0249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2707 E 21ST ST N",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672142249",
            "telephone_number": "316-691-0249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLISS",
        "first_name": "KRISTIN",
        "middle_name": "LEE",
        "credential": "APRN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-07",
        "last_updated": "2024-11-07",
        "certification_date": "2024-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "53-83770-112",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "1634839",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTIN",
            "last_name": "MCENTIRE",
            "middle_name": "LEE",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.