Individual provider Active NPI

Jennifer Gutierrez, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Wichita, KS
National Provider Identifier
1467164087
Registry record updated Dec 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
81777 Issued in KS
Practice address
350 S Broadway Ave
Wichita, KS 67202-4304
Phone
(316) 660-9600
NPI assigned
Dec 14, 2022
Last updated
Dec 14, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 81777 KS Primary

Addresses

Primary practice location

350 S Broadway Ave
Wichita, KS 67202-4304

Mailing address

271 W 3Rd St N Ste 600
Wichita, KS 67202-1223
Phone (316) 660-7600

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
I20221220002567 KS Practitioner - Nurse Practitioner 0446620132 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
81777KSMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
County of Sedgwick CurrentSince Dec 19, 2022 Accepting new patients
County of Sedgwick Current Accepting new patients
KVC Hospitals Inc Past Accepting new patients
KVC Hospitals Inc Past Accepting new patients
KVC Hospitals Inc Past Accepting new patients
KVC Hospitals Inc Past Accepting new patients

Locations

271 W 3rd St N
Ste 600
Wichita, KS 67202

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1670976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670976000000",
    "number": "1467164087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "271 W 3RD ST N STE 600",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672021223",
            "telephone_number": "316-660-7600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 S BROADWAY AVE",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672024304",
            "telephone_number": "316-660-9600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "JENNIFER",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-14",
        "last_updated": "2022-12-14",
        "certification_date": "2022-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KS",
            "license": "81777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.