Individual provider Active NPI

Jenny A Manry, ARNP-C

  • Nurse Practitioner
  • Great Bend, KS
National Provider Identifier
1568415396
Registry record updated Jul 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
45344 Issued in KS
Practice address
3520 Lakin Ave
Suite 103
Great Bend, KS 67530-3646
Phone
(620) 792-3345
Fax
(620) 792-3767
NPI assigned
May 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 45344 KS Primary

Addresses

Primary practice location

3520 Lakin Ave
Suite 103
Great Bend, KS 67530-3646

Mailing address

3520 Lakin Ave
Suite 103
Great Bend, KS 67530-3646
Phone (620) 792-3345

Other identifiers 1

IdentifierTypeStateIssuer
200001980AMedicaidKS

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
I20031211000165 KS Practitioner - Nurse Practitioner 5890691612 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Heart of Kansas Family Health Care IncGroup PAC ID 4486565181, 17 clinicians

Practice addresses (Care Compare)

1905 19TH St
Great Bend, KS 67530-2502
Phone (620) 792-5700

Hospital & facility affiliations

  • Pawnee Valley Community Hospital Hospital, Larned, KS, CCN 171345

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
45344KSMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Heart of Kansas Family Health Care, Inc. CurrentSince Dec 19, 2019 Accepting new patients
Heart of Kansas Family Health Care, Inc. CurrentSince Dec 19, 2019 Accepting new patients
Central Kansas Medical Center Past Accepting new patients
Hays Medical Center, Inc. Past Accepting new patients

Locations

1905 19th St
Great Bend, KS 67530
Phone (620) 792-5700

522 Broadway St
Larned, KS 67550
Phone (620) 804-6007

Interoperability endpoints

  • Direct secure messaging: jenny.manry@khindirect.org
  • FHIR API: https://api.platform.athenahealth.com/20094/brand/1/csg/1/fhir/r4
  • Direct secure messaging: jenny.manry.1@20094.direct.athenahealth.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248912000000",
    "number": "1568415396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3520 LAKIN AVE",
            "address_2": "SUITE 103",
            "city": "GREAT BEND",
            "state": "KS",
            "postal_code": "675303646",
            "telephone_number": "620-792-3345",
            "fax_number": "620-792-3767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3520 LAKIN AVE",
            "address_2": "SUITE 103",
            "city": "GREAT BEND",
            "state": "KS",
            "postal_code": "675303646",
            "telephone_number": "620-792-3345",
            "fax_number": "620-792-3767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANRY",
        "first_name": "JENNY",
        "middle_name": "A",
        "credential": "ARNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-19",
        "last_updated": "2009-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KS",
            "license": "45344",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200001980A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Bend, KS

Sources for this page

Verify at the official NPI Registry.