Gail L Boaldin
Individual provider Active NPI Family Nurse Practitioner · Wichita, KS
NPI 1568989341 · NPPES record last updated Aug 23, 2017
Key facts
- NPI
- 1568989341
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 53-77823 (KS)
- Practice address
- 3701 E 13TH St N
Wichita, KS 67208-2014 - Phone
- (316) 866-2000
- NPI assigned
- Aug 23, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Hillsboro Hospital LLC
Practice addresses (Care Compare)
101 Industrial Rd
Hillsboro, KS 67063-9602
Phone (620) 877-4165
Hospital & facility affiliations
- Hillsboro Community Hospital
- Hillsboro Community Hospital
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 |
|---|---|---|---|---|
| I20170912001174 | KS | Practitioner - Nurse Practitioner | 2961775010 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 53-77823 | KS | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hillsboro Hospital LLC | Current |
Accepting new patients | |
| Hillsboro Hospital LLC | Current | Accepting new patients | |
| Hillsboro Hospital LLC | Past | Accepting new patients |
Locations
101 Industrial Rd
Hillsboro, KS 67063
Phone (620) 877-4165
101 Industrial Rd
Ste A
Hillsboro, KS 67063
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 53-77823 | KS | Yes |
Addresses
Primary practice location
3701 E 13TH St N
Wichita, KS 67208-2014
Mailing address
2008 Nighthawk
Marion, KS 66861-9148
Other providers in Wichita, KS
- Bluechip Spine & Sports Specialists, LLC
- Bluestem Acupuncture Clinic of Kansas LLC
- Richard Matthew Blumenshine
- Patricia J Bluml
- Jaclyn Blyholder
- Subhadra Navya Bodla
- Kelby Bodley
- Andrea Bodwell
- Body and Mind Solutions LLC
- Body Medical HHA
All providers in Wichita, KS · Family 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 Aug 23, 2017. 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).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.