Shanell Bosch, AGACNP-BC
Individual provider Active NPI Acute Care Nurse Practitioner · Wichita, KS
NPI 1497534465 · NPPES record last updated Sep 27, 2023
Key facts
- NPI
- 1497534465
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Acute Care Nurse Practitioner 363LA2100X
- License
- 82483 (KS)
- Practice address
- 2122 N 127TH CT E
Wichita, KS 67206-3003 - Phone
- (620) 635-6454
- NPI assigned
- Sep 27, 2023
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240124000347 | KS | Practitioner - Nurse Practitioner | 6901258185 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 120305 | KS | MD | Registered Nurse |
| 82483 | KS | MD | Acute Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ascension Via Christi Hospitals Wichita Inc. | Current |
Accepting new patients | |
| Ascension Via Christi Hospitals Wichita Inc. | Current |
Accepting new patients |
Locations
929 N Saint Francis Ave
Wichita, KS 67214
Phone (316) 291-4396
Interoperability endpoints
- https://api.platform.athenahealth.com/20807/brand/4/csg/1/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 120305 | KS | |
| Acute Care Nurse Practitioner | 363LA2100X | 82483 | KS | Yes |
Addresses
Primary practice location
2122 N 127TH CT E
Wichita, KS 67206-3003
Mailing address
2122 N 127TH CT E
Wichita, KS 67206-3003
Phone (620) 635-6454
Other providers in Wichita, KS
- Kate Borniger
- Jesse Borosky
- Cory August Borsdorf
- Ellen E. Borst
- Jeffrey E Bosanco
- Janet Boschert Boschert
- Michael S Bosh
- Trisha L Bosken
- Kresta L Bosley
- Autumn Boss
All providers in Wichita, KS · Acute Care Nurse Practitioner in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 27, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.