Individual provider Active NPI

Susan Wessel

  • Surgical Physician Assistant
  • Wichita, KS
National Provider Identifier
1427018555
Registry record updated Jul 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
15-00640 Issued in KS
Practice address
5500 E Kellogg Dr
Wichita, KS 67218-1607
Phone
(316) 685-2221
NPI assigned
Mar 24, 2006
Last updated
Jul 18, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 15-00640 KS Primary

Addresses

Primary practice location

5500 E Kellogg Dr
Wichita, KS 67218-1607

Mailing address

5500 E Kellogg Dr
Wichita, KS 67218-1607

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
I20110823000372 KS Order and Referring Only - Physician Assistant 5395783112

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
15-00640KSMDSurgical Physician Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184716800000",
    "number": "1427018555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 E KELLOGG DR",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672181607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 E KELLOGG DR",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672181607",
            "telephone_number": "316-685-2221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WESSEL",
        "first_name": "SUSAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-24",
        "last_updated": "2007-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "KS",
            "license": "15-00640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.