Michelle Van Der Wege

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

77268 Issued in KS

Practice address

522 Broadway St
Larned, KS 67550-3042

Phone

(620) 804-6100

Fax

(620) 804-6055

NPI assigned

Jun 16, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/20094/brand/1/csg/1/fhir/r4

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.

• Heart of Kansas Family Health Care, Inc.

  • Federally Qualified Health Center (FQHC)
  • Great Bend, KS
  • NPI 1184739443
  Medicare reassignment NPD
• Heart of Kansas Family Health Care, Inc.

  • Federally Qualified Health Center (FQHC)
  • Great Bend, KS
  • NPI 1154136612
  NPD

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

{
    "created_epoch": "1466035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722297600000",
    "number": "1700236114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1905 19TH ST",
            "city": "GREAT BEND",
            "state": "KS",
            "postal_code": "675302502",
            "telephone_number": "620-792-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "522 BROADWAY ST",
            "city": "LARNED",
            "state": "KS",
            "postal_code": "675503042",
            "telephone_number": "620-804-6100",
            "fax_number": "620-804-6055"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "FHSU Student Health",
            "address_2": "600 Park St # LL045MU",
            "address_purpose": "LOCATION",
            "city": "HAYS",
            "state": "KS",
            "postal_code": "676016760",
            "country_code": "US",
            "telephone_number": "785-628-4401",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAN DER WEGE",
        "first_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-16",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KS",
            "license": "77268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sunrise, Inc,
• Dyann Tauscher, LAC, LCPC
• Abigail Marie Taylor, PSY.D.
• Trinity Medical Associates
• Stacy Renee' Trout, PA-C
• Thomas A. Van Dillen
• Tayleene Marie Van Norden
• Mark Ethan Vannorden, D.O.
• Lindsey M Vansickle, D.C.
• Jean Vil, MD

• Nurse Practitioner in Larned, KS
• Providers in Larned, KS by specialty
• Nurse Practitioner in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.