Individual provider Active NPI

Jennifer Marie Love, APRN-BC

  • Family Nurse Practitioner
  • Arkansas City, KS
National Provider Identifier
1699431346
Registry record updated Jun 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2021161664 Issued in KS
Practice address
6401 Patterson Pkwy
Arkansas City, KS 67005-5701
Phone
(620) 441-5771
NPI assigned
Nov 16, 2021
Last updated
Jun 2, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2021161664 KS Primary
Registered Nurse 163W00000X 13140674091 KS
General Practice Registered Nurse 163WG0000X 13-140674091 KS

Addresses

Primary practice location

6401 Patterson Pkwy
Arkansas City, KS 67005-5701

Mailing address

1824 Booth St
Winfield, KS 67156-4724
Phone (620) 218-2423

Other names 1

  • Jennifer Marie Russom Former name

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
I20220427002510 KS Practitioner - Nurse Practitioner 5092102780 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Maria Medical Group LLCGroup PAC ID 5991936403, 15 clinicians

Practice addresses (Care Compare)

3161 N Rock Rd a
Afc Doctors Express
Wichita, KS 67226-1312
Phone (316) 440-2712

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13140674091KSMDRegistered Nurse
13-140674091KSMDGeneral Practice Registered Nurse
2021161664KSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Maria Medical Group, LLC CurrentSince Jun 11, 2025 Accepting new patients
Urgent Care of Cowley County LLC CurrentSince Sep 1, 2024 Accepting new patients
Theoria Medical CurrentSince Apr 11, 2025 Accepting new patients

Locations

605 E Melvin St
Arma, KS 66712
Phone (620) 347-4103

3161 N Rock Rd
Wichita, KS 67226
Phone (316) 440-2712

3161 N Rock Rd
Ste A
Wichita, KS 67226
Phone (316) 440-2712

1305 E 19th Ave
Winfield, KS 67156
Phone (620) 221-9500

41800 W 11 Mile Rd
Ste 109
Novi, MI 48375
Phone (833) 578-2763

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.

NPI Registry JSON

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

{
    "created_epoch": "1637020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748822400000",
    "number": "1699431346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1824 BOOTH ST",
            "city": "WINFIELD",
            "state": "KS",
            "postal_code": "671564724",
            "telephone_number": "620-218-2423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6401 PATTERSON PKWY",
            "city": "ARKANSAS CITY",
            "state": "KS",
            "postal_code": "670055701",
            "telephone_number": "620-441-5771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOVE",
        "first_name": "JENNIFER",
        "middle_name": "MARIE",
        "credential": "APRN-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-16",
        "last_updated": "2025-06-02",
        "certification_date": "2025-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "2021161664",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KS",
            "license": "13140674091",
            "primary": false
        },
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "KS",
            "license": "13-140674091",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "RUSSOM",
            "middle_name": "MARIE",
            "credential": "APRN-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Arkansas City, KS

Sources for this page

Verify at the official NPI Registry.