NPIMap

Individual provider Active NPI

Kendra Elaine Mitteis, NP

  • Family Nurse Practitioner
  • Verdigre, NE
National Provider Identifier
1306544465
Registry record updated Feb 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
114642 Issued in NE
Practice address
401 James St
Verdigre, NE 68783-6149
Phone
(402) 668-2216
NPI assigned
Feb 20, 2023
Last updated
Feb 20, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2023

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 114642 NE Primary

Addresses

Primary practice location

401 James St
Verdigre, NE 68783-6149

Mailing address

401 James St
Verdigre, NE 68783-6149
Phone (402) 668-2216

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230315002511 NE Practitioner - Nurse Practitioner 7618341504 Reassigns benefits to 3 organizations

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
Sacred Heart Health ServicesGroup PAC ID 6103729066, shared by 17 NPIs, 151 clinicians

Practice addresses (Care Compare)

1503 Main St
Creighton, NE 68729-3007
Phone (402) 358-5700

401 James St
Verdigre, NE 68783-6149
Phone (402) 668-2216

405 W Darlene St
Avera Behavioral Health Yankton
Hartington, NE 68739-0937
Phone (402) 254-3935

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
114642NEMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sacred Heart Health Services CurrentSince Mar 15, 2023 Accepting new patients
Sacred Heart Health Services CurrentSince Mar 15, 2023 Accepting new patients
Sacred Heart Health Services Current Accepting new patients
Sacred Heart Health Services CurrentSince Mar 15, 2023 Accepting new patients
Sacred Heart Health Services Current Accepting new patients
Sacred Heart Health Services Current Accepting new patients
Sacred Heart Health Services Past Accepting new patients

Locations

1503 Main St
Creighton, NE 68729
Phone (402) 358-5700

Interoperability endpoints

  • Direct secure messaging: kendra.mitteis@avera.sdhealthlink.net

Organizations & group practices 7

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 9

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": "1676851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676851200000",
    "number": "1306544465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 JAMES ST",
            "city": "VERDIGRE",
            "state": "NE",
            "postal_code": "687836149",
            "telephone_number": "402-668-2216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 JAMES ST",
            "city": "VERDIGRE",
            "state": "NE",
            "postal_code": "687836149",
            "telephone_number": "402-668-2216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITTEIS",
        "first_name": "KENDRA",
        "middle_name": "ELAINE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-20",
        "last_updated": "2023-02-20",
        "certification_date": "2023-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NE",
            "license": "114642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Verdigre, NE

Sources for this page

Verify at the official NPI Registry.