NPIMap

Organization Active NPI

Luminary Behavioral Health LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Derby, KS
National Provider Identifier
1437866084
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
LUMINARY BEHAVIORAL HEALTH LLC
Practice address
425 N Baltimore Ave Ste 5
Derby, KS 67037-1625
Phone
(316) 260-7900
NPI assigned
Nov 2, 2022
Last updated
Mar 7, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Authorized official

Name
Nicole Xanders-Danler, PMHNP-BCNPI 1083374292
Title
Owner
Phone
(316) 260-7900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NU Primary

Addresses

Primary practice location

425 N Baltimore Ave Ste 5
Derby, KS 67037-1625

Mailing address

PO Box 834
Derby, KS 67037-0834
Phone (316) 260-7900

Other practice location 1

6189 Lehman Dr Ste 102
Colorado Springs, CO 80918-5409
Phone (316) 260-7900

Other practice location 2

2501 N Tejon St
Colorado Springs, CO 80907-6836
Phone (316) 260-7900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS, CO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20230203000583 KS Part B Supplier - Clinic/Group Practice 2365814142 Receives reassigned benefits from 6 practitioners
Practice locations: Derby, KS
O20230328000513 CO Part B Supplier - Clinic/Group Practice 2365814142 Receives reassigned benefits from 2 practitioners
Practice locations: Colorado Springs, CO

National Provider Directory

National Provider Directory

Locations

425 N Baltimore Ave
Ste 5
Derby, KS 67037
Phone (316) 260-7900

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1667347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1437866084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 834",
            "city": "DERBY",
            "state": "KS",
            "postal_code": "670370834",
            "telephone_number": "316-260-7900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 N BALTIMORE AVE STE 5",
            "city": "DERBY",
            "state": "KS",
            "postal_code": "670371625",
            "telephone_number": "316-260-7900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6189 Lehman Dr Ste 102",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809185409",
            "country_code": "US",
            "telephone_number": "316-260-7900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2501 N Tejon St",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809076836",
            "country_code": "US",
            "telephone_number": "316-260-7900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LUMINARY BEHAVIORAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-02",
        "last_updated": "2023-03-07",
        "certification_date": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "XANDERS-DANLER",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "316-260-7900",
        "authorized_official_credential": "PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Derby, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.