Individual provider Active NPI

Amanda Marie Root, MS

  • Professional Counselor
  • Wichita, KS
National Provider Identifier
1871822965
Registry record updated Dec 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2339 Issued in KS
Practice address
2420 N Woodlawn Blvd Ste 300
Wichita, KS 67220-3960
Phone
(316) 347-7157
NPI assigned
Dec 18, 2009
Last updated
Dec 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X #PPC-501 WY
Addiction (Substance Use Disorder) Counselor 101YA0400X 997 KS
Professional Counselor 101YP2500X 2339 KS Primary

Addresses

Primary practice location

2420 N Woodlawn Blvd Ste 300
Wichita, KS 67220-3960

Mailing address

2420 N Woodlawn Blvd Ste 300
Wichita, KS 67220-3960
Phone (316) 347-7157

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241224000997 KS Practitioner - Mental Health Counselor 5092242479 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Air Capital Counseling and Assessment LLCGroup PAC ID 7012440324, 6 clinicians

Practice addresses (Care Compare)

2420 N Woodlawn Blvd
BLDG 300
Wichita, KS 67220-3960
Phone (316) 347-7157

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
#PPC-501WYMDCounselor
997KSMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Air Capital Counseling & Assessment, LLC Professional CurrentSince Nov 1, 2024 Accepting new patients

Locations

2420 N Woodlawn Blvd
Ste 300
Wichita, KS 67220
Phone (316) 347-7157

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1261094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733702400000",
    "number": "1871822965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2420 N WOODLAWN BLVD STE 300",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672203960",
            "telephone_number": "316-347-7157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2420 N WOODLAWN BLVD STE 300",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672203960",
            "telephone_number": "316-347-7157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROOT",
        "first_name": "AMANDA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-18",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WY",
            "license": "#PPC-501",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "KS",
            "license": "997",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "KS",
            "license": "2339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.