Active NPI
Jean Dedonder, PH.D., A.P.R.N.
- Nurse Practitioner
- Manhattan, KS
National Provider Identifier
1487067542
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 5374002
- Practice address
- 1105 Sunset Ave
Manhattan, KS 66502-3739 - Phone
- (785) 532-7755
- Fax
- (785) 532-6627
- NPI assigned
- Jun 6, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 5374002 | KS | Primary |
Addresses
Primary practice location
1105 Sunset Ave
Manhattan, KS 66502-3739
Mailing address
1105 Sunset Ave
Manhattan, KS 66502-3739
Phone (785) 532-7755
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5374002 | KS | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1402012800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1402012800000",
"number": "1487067542",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1105 SUNSET AVE",
"city": "MANHATTAN",
"state": "KS",
"postal_code": "665023739",
"telephone_number": "785-532-7755",
"fax_number": "785-532-6627"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1105 SUNSET AVE",
"city": "MANHATTAN",
"state": "KS",
"postal_code": "665023739",
"telephone_number": "785-532-7755",
"fax_number": "785-532-6627"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEDONDER",
"first_name": "JEAN",
"credential": "PH.D., A.P.R.N.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-06-06",
"last_updated": "2014-06-06",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "KS",
"license": "5374002",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Manhattan, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.