Individual provider Active NPI

Betsy J Stander, APN

  • Obstetrics & Gynecology Nurse Practitioner
  • Overland Park, KS
National Provider Identifier
1376981357
Registry record updated Jun 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X
License
TMP147024 Issued in KS
Practice address
4550 W 109TH St
Suite 130
Overland Park, KS 66211-1360
Phone
(913) 307-3198
NPI assigned
Jun 12, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Nurse Practitioner 363LX0001X TMP147024 KS Primary

Addresses

Primary practice location

4550 W 109TH St
Suite 130
Overland Park, KS 66211-1360

Mailing address

4550 W 109TH St
Suite 130
Overland Park, KS 66211-1360
Phone (913) 307-3198

Other names 1

  • Betsy J Porto Former 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
I20160303001277 KS Order and Referring Only - Nurse Practitioner 6709182587

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TMP147024KSMDObstetrics & Gynecology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
James Mirabile MD PA Past Accepting new patients

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": "1370995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370995200000",
    "number": "1376981357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4550 W 109TH ST",
            "address_2": "SUITE 130",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662111360",
            "telephone_number": "913-307-3198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4550 W 109TH ST",
            "address_2": "SUITE 130",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662111360",
            "telephone_number": "913-307-3198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANDER",
        "first_name": "BETSY",
        "middle_name": "J",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-12",
        "last_updated": "2013-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "KS",
            "license": "TMP147024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BETSY",
            "last_name": "PORTO",
            "middle_name": "J",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Overland Park, KS

Sources for this page

Verify at the official NPI Registry.