Individual provider Active NPI

Jennifer Mettling

  • Family Medicine Physician
  • Wichita, KS
National Provider Identifier
1629643424
Registry record updated May 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
94-10483 Issued in KS
Practice address
1010 N Kansas St
Wichita, KS 67214-3124
Phone
(316) 293-2665
NPI assigned
May 24, 2021
Last updated
May 24, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 94-10483 KS Primary

Addresses

Primary practice location

1010 N Kansas St
Wichita, KS 67214-3124

Mailing address

1010 N Kansas St
Wichita, KS 67214-3124
Phone (316) 293-2665

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241004000427 KS Practitioner - Family Practice 5496159519 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Kansas School of Med (KC/Wich/Sal), 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

239 N Broadway Ave
Sterling Med Center
Sterling, KS 67579-1916
Phone (620) 278-2123

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital District No 1 of Rice Co CurrentSince Sep 17, 2024 Accepting new patients
Hospital District No 1 of Rice Co CurrentSince Sep 17, 2024 Accepting new patients
Hospital District No 1 of Rice Co Family Medicine Past Accepting new patients
Medical Center, P.a. Past Accepting new patients

Locations

619 S Clark Ave
Lyons, KS 67554
Phone (620) 257-5173

239 N Broadway Ave
Sterling, KS 67579
Phone (620) 278-2123

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1621814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621814400000",
    "number": "1629643424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 N KANSAS ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672143124",
            "telephone_number": "316-293-2665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 N KANSAS ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672143124",
            "telephone_number": "316-293-2665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "METTLING",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-24",
        "last_updated": "2021-05-24",
        "certification_date": "2021-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "94-10483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.