Individual provider Active NPI

Ryan Patrick Prebble

  • Acute Care Nurse Practitioner
  • Wichita, KS
National Provider Identifier
1730697012
Registry record updated Jan 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
78028 Issued in KS
Practice address
3600 E Harry St
Wichita, KS 67218-3713
Phone
(316) 268-5000
NPI assigned
Jan 20, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 78028 KS Primary

Addresses

Primary practice location

3600 E Harry St
Wichita, KS 67218-3713

Mailing address

10111 E 21St St N Ste 106
Wichita, KS 67206-3555
Phone (316) 351-7687

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
I20180228001178 KS Practitioner - Nurse Practitioner 2769743194 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kansas Orthopaedic Center, PAGroup PAC ID 3577553668, 24 clinicians

Practice addresses (Care Compare)

7550 W Village Cir
Suite 1
Wichita, KS 67205-9364
Phone (316) 838-2020

Hospital & facility affiliations

  • Wesley Medical Center Hospital, Wichita, KS, CCN 170123
  • Kansas Spine & Specialty Hospital, LLC Hospital, Wichita, KS, CCN 170196
  • Ascension Via Christi Hospitals Wichita, Inc. Hospital, Wichita, KS, CCN 170122

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
78028KSMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Inpatient Consultants of Kansas PA CurrentSince Mar 1, 2018 Accepting new patients
Kansas Orthopaedic Center, P.a. CurrentSince Jan 23, 2021 Accepting new patients
Inpatient Consultants of Kansas PA CurrentSince Mar 1, 2018 Accepting new patients
Kansas Orthopaedic Center, P.a. CurrentSince Jan 23, 2021 Accepting new patients
Dan a Francisco MD PA PastSince May 1, 2018 Accepting new patients

Locations

1124 W 21st St
Andover, KS 67002
Phone (316) 300-4000

9100 W 74th St
Shawnee Msn, KS 66204
Phone (913) 632-2230

7550 W Village Cir
Ste 1
Wichita, KS 67205
Phone (316) 838-2020

7550 W Village Cir
Wichita, KS 67205
Phone (316) 838-2020

3600 E Harry St
Wichita, KS 67218
Phone (316) 268-5426

Organizations & group practices 5

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.

Hospital & facility affiliations 5

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": "1516406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548115200000",
    "number": "1730697012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10111 E 21ST ST N STE 106",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672063555",
            "telephone_number": "316-351-7687",
            "fax_number": "316-440-6084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 E HARRY ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672183713",
            "telephone_number": "316-268-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PREBBLE",
        "first_name": "RYAN",
        "middle_name": "PATRICK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-01-20",
        "last_updated": "2019-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "KS",
            "license": "78028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.