Individual provider Active NPI

Kayla Witterick, APRN

  • Nurse Practitioner
  • Newton, KS
National Provider Identifier
1902403413
Registry record updated Jan 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
79685 Issued in KS
Practice address
1901 E 1St St
Newton, KS 67114-5010
Phone
(316) 284-6400
Fax
(316) 284-6490
NPI assigned
Oct 7, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 79685 KS Primary

Addresses

Primary practice location

1901 E 1St St
Newton, KS 67114-5010

Mailing address

PO Box 467
Newton, KS 67114-0467
Phone (316) 284-6400

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
I20201123002074 KS Practitioner - Nurse Practitioner 0648681619 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prairie View IncGroup PAC ID 5496652471, 27 clinicians

Practice addresses (Care Compare)

1901 E 1St St
Newton, KS 67114-5010
Phone (316) 284-6400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
79685KSMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
County of Sedgwick CurrentSince Oct 13, 2020 Accepting new patients
County of Sedgwick Current Accepting new patients
Prairie View Inc Past Accepting new patients

Locations

1919 N Amidon Ave
Ste 130
Wichita, KS 67203
Phone (316) 660-7675

271 W 3rd St N
Ste 600
Wichita, KS 67202

Organizations & group practices 4

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": "1602028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674172800000",
    "number": "1902403413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 467",
            "city": "NEWTON",
            "state": "KS",
            "postal_code": "671140467",
            "telephone_number": "316-284-6400",
            "fax_number": "316-284-6490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 E 1ST ST",
            "city": "NEWTON",
            "state": "KS",
            "postal_code": "671145010",
            "telephone_number": "316-284-6400",
            "fax_number": "316-284-6490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITTERICK",
        "first_name": "KAYLA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-07",
        "last_updated": "2023-01-20",
        "certification_date": "2023-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KS",
            "license": "79685",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newton, KS

Sources for this page

Verify at the official NPI Registry.