Active NPI
Beatrice Tang Disasi
- Nursing Home Administrator
- Wichita, KS
National Provider Identifier
1760900328
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nursing Home Administrator
- License
- 264
- Practice address
- 12526 E Central Ave
Wichita, KS 67206-2812 - Phone
- (316) 616-5306
- Fax
- (316) 260-9229
- NPI assigned
- Sep 5, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nursing Home Administrator | 376G00000X | 264 | KS | Primary |
Addresses
Primary practice location
12526 E Central Ave
Wichita, KS 67206-2812
Mailing address
PO Box 780204
Wichita, KS 67278-0204
Phone (316) 616-5306
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 82-2384276 | Medicaid | KS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 264 | KS | MD | Nursing Home Administrator |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1504569600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1529107200000",
"number": "1760900328",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 780204",
"city": "WICHITA",
"state": "KS",
"postal_code": "672780204",
"telephone_number": "316-616-5306"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12526 E CENTRAL AVE",
"city": "WICHITA",
"state": "KS",
"postal_code": "672062812",
"telephone_number": "316-616-5306",
"fax_number": "316-260-9229"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DISASI",
"first_name": "BEATRICE",
"middle_name": "TANG",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-09-05",
"last_updated": "2018-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "376G00000X",
"taxonomy_group": "",
"desc": "Nursing Home Administrator",
"state": "KS",
"license": "264",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "82-2384276",
"state": "KS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wichita, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.