Individual provider Active NPI

Emma A Ndungu

  • Family Nurse Practitioner
  • Wichita, KS
National Provider Identifier
1275392342
Registry record updated Mar 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
53-82936-061 Issued in KS
Practice address
7607 E Harry St
Wichita, KS 67207-3111
Phone
(316) 869-0015
Fax
(316) 618-0414
NPI assigned
Mar 18, 2024
Last updated
Mar 18, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 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 53-82936-061 KS Primary

Addresses

Primary practice location

7607 E Harry St
Wichita, KS 67207-3111

Mailing address

1152 N Linden Cir
Wichita, KS 67206-4084
Phone (316) 992-2331

Other practice location 1

1152 N Linden Cir
Wichita, KS 67206-4084
Phone (316) 992-2331

Other names 1

  • Dr. Emma A Oduka Professional 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
I20240826002053 KS Practitioner - Nurse Practitioner 4688113343 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
53-82936-061KSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Gracemed Health Clinic, Inc CurrentSince Aug 19, 2024 Accepting new patients
Gracemed Health Clinic Inc CurrentSince Aug 19, 2024 Accepting new patients

Locations

1122 N Topeka St
Wichita, KS 67214
Phone (316) 263-7455

1150 N Broadway Ave
Wichita, KS 67214

3417 S Meridian Ave
Wichita, KS 67217
Phone (316) 866-2078

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1710720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710720000000",
    "number": "1275392342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1152 N LINDEN CIR",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672064084",
            "telephone_number": "316-992-2331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7607 E HARRY ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672073111",
            "telephone_number": "316-869-0015",
            "fax_number": "316-618-0414"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1152 N Linden Cir",
            "address_purpose": "LOCATION",
            "city": "Wichita",
            "state": "KS",
            "postal_code": "672064084",
            "country_code": "US",
            "telephone_number": "316-992-2331",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NDUNGU",
        "first_name": "EMMA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-18",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "53-82936-061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMMA",
            "last_name": "ODUKA",
            "middle_name": "A",
            "prefix": "DR.",
            "credential": "APRN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.