Individual provider Active NPI

Stacy Lynn Wessley, APRN

  • Nurse Practitioner
  • Wichita, KS
National Provider Identifier
1760623011
Registry record updated Apr 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
53-46213-081 Issued in KS
Practice address
3334 N Grey Meadow CT
Wichita, KS 67205-8716
Phone
(316) 992-7900
Fax
(913) 730-7624
NPI assigned
Mar 17, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 53-46213-081 KS Primary

Addresses

Primary practice location

3334 N Grey Meadow CT
Wichita, KS 67205-8716

Mailing address

3334 N Grey Meadow CT
Wichita, KS 67205-8716
Phone (316) 992-7900

Other identifiers 1

IdentifierTypeStateIssuer
200603090AMedicaidKS

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
I20090604000308 KS Practitioner - Nurse Practitioner 5799835245 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
53-46213-081KSMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health Medical Associates of Kansas LLC CurrentSince Mar 16, 2023 Accepting new patients
Midwest Psychiatric Services, LLC CurrentSince Apr 1, 2020 Accepting new patients
Neurology Consultants of Kansas LLC PastSince Jul 18, 2022 Accepting new patients
Kansas Long Term Care Physicians, LLC Past Accepting new patients
Wichita Medical Associates, PA PastSince Dec 5, 1992 Accepting new patients

Locations

1131 S Clifton Ave
Ste B
Wichita, KS 67218
Phone (316) 462-1040

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FJHFCD

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.

NPI Registry JSON

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

{
    "created_epoch": "1237248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493078400000",
    "number": "1760623011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3334 N GREY MEADOW CT",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672058716",
            "telephone_number": "316-992-7900",
            "fax_number": "913-730-7624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3334 N GREY MEADOW CT",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672058716",
            "telephone_number": "316-992-7900",
            "fax_number": "913-730-7624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WESSLEY",
        "first_name": "STACY",
        "middle_name": "LYNN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-17",
        "last_updated": "2017-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KS",
            "license": "53-46213-081",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200603090A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.