Individual provider Active NPI

Mallory Renee Capps, APRN, FNP-C

  • Family Nurse Practitioner
  • Wichita, KS
National Provider Identifier
1285278200
Registry record updated Nov 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
78579 Issued in KS
Practice address
551 S Holland St
Wichita, KS 67209-2007
Phone
(316) 260-1435
NPI assigned
Nov 1, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2019

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 78579 KS Primary

Addresses

Primary practice location

551 S Holland St
Wichita, KS 67209-2007

Mailing address

551 S Holland St
Wichita, KS 67209-2007
Phone (316) 260-1435

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
78579KSMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1572566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572566400000",
    "number": "1285278200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "551 S HOLLAND ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672092007",
            "telephone_number": "316-260-1435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "551 S HOLLAND ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672092007",
            "telephone_number": "316-260-1435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAPPS",
        "first_name": "MALLORY",
        "middle_name": "RENEE",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-01",
        "last_updated": "2019-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "78579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.