Individual provider Active NPI

Emily A Caudle, APRN

  • Nurse Practitioner
  • Topeka, KS
National Provider Identifier
1396091153
Registry record updated Mar 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
53-75735 Issued in KS
Practice address
823 SW Mulvane St
Topeka, KS 66606-1764
Phone
(785) 354-9591
NPI assigned
Jul 31, 2012
Last updated
Mar 26, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 53-75735 KS Primary
Registered Nurse 163W00000X 13-110159 KS

Addresses

Primary practice location

823 SW Mulvane St
Topeka, KS 66606-1764

Mailing address

823 SW Mulvane St
Topeka, KS 66606-1764
Phone (785) 354-9591

Other identifiers 2

IdentifierTypeStateIssuer
068002208OtherKSMEDICARE PTAN
200963850AMedicaidKS

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
I20130318000058 KS Practitioner - Nurse Practitioner 6800031014 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prairie Band Potawatomi NationGroup PAC ID 7719921907, 5 clinicians

Practice addresses (Care Compare)

11400 158TH Rd
Mayetta, KS 66509-8866
Phone (785) 966-8200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13-110159KSMDRegistered Nurse
53-75735KSMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Prairie Band Potawatomi Nation CurrentSince Sep 8, 2020 Accepting new patients
Prairie Band Potawatomi Nation CurrentSince Sep 8, 2020 Accepting new patients

Locations

11400 158th Rd
Mayetta, KS 66509
Phone (785) 966-8200

Organizations & group practices 2

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 4

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": "1343692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364256000000",
    "number": "1396091153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "823 SW MULVANE ST",
            "city": "TOPEKA",
            "state": "KS",
            "postal_code": "666061764",
            "telephone_number": "785-354-9591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "823 SW MULVANE ST",
            "city": "TOPEKA",
            "state": "KS",
            "postal_code": "666061764",
            "telephone_number": "785-354-9591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAUDLE",
        "first_name": "EMILY",
        "middle_name": "A",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-31",
        "last_updated": "2013-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KS",
            "license": "53-75735",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KS",
            "license": "13-110159",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "068002208",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200963850A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Topeka, KS

Sources for this page

Verify at the official NPI Registry.