Abby Lee Bornholdt, APRN
Individual provider Active NPI Gerontology Nurse Practitioner · Wichita, KS
NPI 1801740824 · NPPES record last updated Mar 3, 2026
Key facts
- NPI
- 1801740824
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Gerontology Nurse Practitioner 363LG0600X
- License
- 85234 (KS)
- Practice address
- 245 N Waco St Ste 220
Wichita, KS 67202-1102 - Phone
- (316) 722-2138
- Fax
- (833) 464-2530
- NPI assigned
- Feb 25, 2026
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2025
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
245 N Waco St
Suite 220
Wichita, KS 67202-1102
Hospital & facility affiliations
- Faith Hospice
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260421000343 | KS | Practitioner - Nurse Practitioner | 5496221053 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 85234 | KS | MD | Gerontology Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gerontology Nurse Practitioner | 363LG0600X | 85234 | KS | Yes |
Addresses
Primary practice location
245 N Waco St Ste 220
Wichita, KS 67202-1102
Mailing address
245 N Waco St Ste 220
Wichita, KS 67202-1102
Phone (316) 722-2138
Other providers in Wichita, KS
- Aimee Boriboun
- Joseph Borick
- Born Midwifery, LLC
- Bob Born
- Kelly Born
- Amy L Bornholdt
- Kate Borniger
- Jesse Borosky
- Cory August Borsdorf
- Ellen E. Borst
All providers in Wichita, KS · Gerontology Nurse Practitioner in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 3, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.