Active NPI
Abby Bertholf
- Family Medicine Physician
- Wichita, KS
National Provider Identifier
1336980812
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 94-11952
- Practice address
- 929 N Saint Francis Ave
Wichita, KS 67214-3821 - Phone
- (316) 268-5000
- NPI assigned
- Jun 6, 2024
- Last updated
- Jun 6, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 94-11952 | KS | Primary |
Addresses
Primary practice location
929 N Saint Francis Ave
Wichita, KS 67214-3821
Mailing address
929 N Saint Francis Ave
Wichita, KS 67214-3821
Phone (316) 268-5000
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: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240626000567 | KS | Order and Referring Only - Family Practice | 9739623273 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1717632000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717632000000",
"number": "1336980812",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "929 N SAINT FRANCIS AVE",
"city": "WICHITA",
"state": "KS",
"postal_code": "672143821",
"telephone_number": "316-268-5000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "929 N SAINT FRANCIS AVE",
"city": "WICHITA",
"state": "KS",
"postal_code": "672143821",
"telephone_number": "316-268-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERTHOLF",
"first_name": "ABBY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-06-06",
"last_updated": "2024-06-06",
"certification_date": "2024-06-06",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "KS",
"license": "94-11952",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wichita, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.