Jennifer Jeannine Nisly, DNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

53-78657-051 Issued in KS

Practice address

1919 N Amidon Ave Ste 100
Wichita, KS 67203-2118

Phone

(316) 866-2000

NPI assigned

Jun 6, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Gracemed Health Clinic Inc

  • Federally Qualified Health Center (FQHC)
  • Wichita, KS
  • NPI 1184691693
  Medicare reassignment NPD
• Gracemed Health Clinic, Inc

  • Federally Qualified Health Center (FQHC)
  • Wichita, KS
  • NPI 1043646870
  NPD
• Gracemed Health Clinic, Inc

  • Federally Qualified Health Center (FQHC)
  • Wichita, KS
  • NPI 1659631695
  NPD (past)
• Gracemed Health Clinic, Inc

  • Federally Qualified Health Center (FQHC)
  • Wichita, KS
  • NPI 1861859787
  NPD (past)

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

{
    "created_epoch": "1559779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581379200000",
    "number": "1891354585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1919 N AMIDON AVE STE 100",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672032118",
            "telephone_number": "620-866-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 N AMIDON AVE STE 100",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672032118",
            "telephone_number": "316-866-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NISLY",
        "first_name": "JENNIFER",
        "middle_name": "JEANNINE",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-06",
        "last_updated": "2020-02-11",
        "certification_date": "2020-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KS",
            "license": "13-118891-051",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "53-78657-051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary C Nilles, ARNP
• Kari Meagan Nilsen, PHD
• Peter J Ninemire, LSCSW, LCAC
• Abhash Niraula, MD
• Andrea Nisly
• Shanna S Nispel, LSCSW
• Shyla Niss
• Shelby Nix
• McKayla Nixon
• Caroline N Njau

• Family Nurse Practitioner in Wichita, KS
• Providers in Wichita, KS by specialty
• Family Nurse Practitioner in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.