Individual provider Active NPI

Sandrine Nkouga, DNP, MSN, FNP-BC

  • Family Nurse Practitioner
  • Wichita, KS
National Provider Identifier
1891142261
Registry record updated Dec 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
53-77084-051 Issued in KS
Practice address
820 N Main St
Wichita, KS 67203-3605
Phone
(316) 202-7051
Fax
(833) 213-7988
NPI assigned
May 16, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 53-77084-051 KS Primary

Addresses

Primary practice location

820 N Main St
Wichita, KS 67203-3605

Mailing address

820 N Main St
Wichita, KS 67203-3605
Phone (316) 202-7051

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS, LA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160712000530 KS Practitioner - Nurse Practitioner 4284926213 Reassigns benefits to 1 organization
I20230524000998 LA Practitioner - Nurse Practitioner 4284926213

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
53-77084-051KSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
American Soldier Evaluation Services Current Accepting new patients

Locations

37283 Swamp Rd
Ste 1001
Prairieville, LA 70769
Phone (225) 673-1088

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": "1463356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640131200000",
    "number": "1891142261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 N MAIN ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672033605",
            "telephone_number": "316-202-7051",
            "fax_number": "833-213-7988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 N MAIN ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672033605",
            "telephone_number": "316-202-7051",
            "fax_number": "833-213-7988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NKOUGA",
        "first_name": "SANDRINE",
        "name_prefix": "Dr.",
        "credential": "DNP, MSN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-16",
        "last_updated": "2021-12-22",
        "certification_date": "2021-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "53-77084-051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.