Individual provider Active NPI

Amber Danelle Good, ARNP

  • Family Nurse Practitioner
  • Wichita, KS
National Provider Identifier
1780199901
Registry record updated Aug 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
77864 Issued in KS
Practice address
347 S Laura St
Wichita, KS 67211-1518
Phone
(316) 686-7117
Fax
(316) 686-2679
NPI assigned
Dec 11, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 77864 KS Primary
Gerontology Nurse Practitioner 363LG0600X 77864 KS

Addresses

Primary practice location

347 S Laura St
Wichita, KS 67211-1518

Mailing address

605 Jayhawk Dr
Cheney, KS 67025-9187
Phone (316) 772-3520

Other identifiers 1

IdentifierTypeStateIssuer
201177650BMedicaidKS

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
I20180116000379 KS Practitioner - Nurse Practitioner 3577822741 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
77864KSMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Kansas School of Medicine Wichita Medical Practice Assoc CurrentSince Feb 7, 2022 Accepting new patients
Ascension Medical Group Via Christi, PA Past Accepting new patients

Locations

1745 W Grand Ave
#260
Haysville, KS 67060
Phone (316) 554-2200

9600 N Meridian Ave
#262
Valley Center, KS 67147
Phone (316) 755-7045

620 N Carriage Pkwy
Wichita, KS 67208
Phone (316) 962-3100

1010 N Kansas St
Wichita, KS 67214
Phone (316) 293-2622

Organizations & group practices 2

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": "1512950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660521600000",
    "number": "1780199901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 JAYHAWK DR",
            "city": "CHENEY",
            "state": "KS",
            "postal_code": "670259187",
            "telephone_number": "316-772-3520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "347 S LAURA ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672111518",
            "telephone_number": "316-686-7117",
            "fax_number": "316-686-2679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOOD",
        "first_name": "AMBER",
        "middle_name": "DANELLE",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-11",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "77864",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "KS",
            "license": "77864",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201177650B",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.