Individual provider Active NPI

Jennifer Danielle Surrell, APRN

  • Family Nurse Practitioner
  • Wichita, KS
National Provider Identifier
1336901925
Registry record updated Jun 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
53-82866-042 Issued in KS
Practice address
4747 S Broadway Ave
Wichita, KS 67216-1739
Phone
(316) 529-3118
NPI assigned
Jan 29, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2025

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 53-82866-042 KS Primary

Addresses

Primary practice location

4747 S Broadway Ave
Wichita, KS 67216-1739

Mailing address

PO Box 932958
Cleveland, OH 44193-0028
Phone (615) 425-4200

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
I20240529003283 KS Practitioner - Nurse Practitioner 8224470794 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Little Clinic of Kansas LLCGroup PAC ID 7416268461, 35 clinicians

Practice addresses (Care Compare)

4747 S Broadway Ave
Wichita, KS 67216-1739
Phone (316) 529-3084

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
53-82866-042KSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Little Clinic of Kansas LLC Family CurrentSince Jun 28, 2024 Accepting new patients

Locations

4747 S Broadway Ave
Wichita, KS 67216
Phone (316) 524-4228

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": "1706486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748995200000",
    "number": "1336901925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 932958",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441930028",
            "telephone_number": "615-425-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4747 S BROADWAY AVE",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672161739",
            "telephone_number": "316-529-3118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SURRELL",
        "first_name": "JENNIFER",
        "middle_name": "DANIELLE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-29",
        "last_updated": "2025-06-04",
        "certification_date": "2025-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "53-82866-042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.