Individual provider Active NPI

Maya R Nunley, D.D.S

  • Dentist
  • Wichita, KS
National Provider Identifier
1558670737
Registry record updated Oct 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
60743 Issued in KS
Practice address
Grace Med Clinic 1122 N. Topeka
Wichita, KS 67214
Phone
(316) 866-2000
Fax
(316) 866-2082
NPI assigned
Oct 5, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 60743 KS Primary

Addresses

Primary practice location

Grace Med Clinic 1122 N. Topeka
Wichita, KS 67214

Mailing address

Wsu Aegd Program
1845 Fairmount
Wichita, KS 67260-0001
Phone (319) 978-3456

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160516000499 KS Order and Referring Only - DentistPractitioner - Dentist 3870882806

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Interoperability endpoints

  • Direct secure messaging: maya.nunley.1@17326.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1286236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286236800000",
    "number": "1558670737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "WSU AEGD PROGRAM",
            "address_2": "1845 FAIRMOUNT",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672600001",
            "telephone_number": "319-978-3456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "GRACE MED CLINIC 1122 N. TOPEKA",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "67214",
            "telephone_number": "316-866-2000",
            "fax_number": "316-866-2082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUNLEY",
        "first_name": "MAYA",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-05",
        "last_updated": "2010-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KS",
            "license": "60743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.