San Juanita Heytens, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

53-81235-122 Issued in KS

Practice address

1513 W Wyatt Earp Blvd
Dodge City, KS 67801-3352

Phone

(620) 682-8304

NPI assigned

Jul 27, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• San Juanita Vargas Former name

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

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Williams Medical Group Practice, LLCGroup PAC ID 3375832157, 212 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Williams Medical Group Practice, LLC

  dba Integrity Urgent Care

  • Family Medicine Physician
  • Lawton, OK
  • NPI 1346608809

  KS

  Medicare reassignment Care Compare group NPD
• Pratt Regional Medical Center Corporation

  dba Pratt Regional Medical Center

  • Rural Acute Care Hospital
  • Pratt, KS
  • NPI 1578596904
  Medicare reassignment
• Williams Medical Group Practice, LLC

  dba Integrity Urgent Care

  • Rural Health Clinic/Center
  • Collinsville, OK
  • NPI 1215751508
  NPD
• Williams Medical Group Practice, LLC

  dba Integrity Urgent Care

  • Rural Health Clinic/Center
  • Tulsa, OK
  • NPI 1750950580
  NPD (past)

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

{
    "created_epoch": "1595808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705708800000",
    "number": "1669081519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1513 W WYATT EARP BLVD",
            "city": "DODGE CITY",
            "state": "KS",
            "postal_code": "678013352",
            "telephone_number": "620-682-8304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1513 W WYATT EARP BLVD",
            "city": "DODGE CITY",
            "state": "KS",
            "postal_code": "678013352",
            "telephone_number": "620-682-8304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEYTENS",
        "first_name": "SAN JUANITA",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-27",
        "last_updated": "2024-01-20",
        "certification_date": "2024-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KS",
            "license": "101659",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "53-81235-122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAN JUANITA",
            "last_name": "VARGAS",
            "credential": "DNP, APRN, FNP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kelly S Henrichs, D.D.S.
• Kirk L Henrichs, D.C.
• Sandra M Herder, APRN
• Brenda Darlene Hernandez, LSCSW
• Stephanie A Hertel, PTA
• High Plaines Foot Specialist PA
• Hodgeman County Medical Services, Inc
• Stephanie A Hornung, RPT
• Hospice of the Prairie, Inc.
• Hospice of the Prairie, Inc.

• Family Nurse Practitioner in Dodge City, KS
• Providers in Dodge City, KS by specialty
• Family Nurse Practitioner in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.