Individual provider Active NPI

Mandy Jo Trimmell, PA-C

  • Physician Assistant
  • Salina, KS
National Provider Identifier
1962060616
Registry record updated Jan 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
15-02306 Issued in KS
Practice address
651 E Prescott Rd
Salina, KS 67401-7408
Phone
(785) 825-7251
NPI assigned
May 29, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 15-02306 KS Primary

Addresses

Primary practice location

651 E Prescott Rd
Salina, KS 67401-7408

Mailing address

1021 Rainbow CT
Buhler, KS 67522-8076

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
I20200226001067 KS Practitioner - Physician Assistant 3971930249 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1640 E Tall Tree Rd
Via Christi Clinic PA
Derby, KS 67037-2000
Phone (316) 789-8222

1947 N Founders Cir
Via Christi Clinic PA
Wichita, KS 67206-3548
Phone (316) 613-4640

3311 E Murdock St
Wichita, KS 67208-3054
Phone (316) 689-9349

818 N Carriage Pkwy
Wichita, KS 67208-4500
Phone (316) 689-9153

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
15-02306KSMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Medical Group Via Christi, PA CurrentSince Dec 3, 2021 Accepting new patients
Ascension Medical Group Via Christi, PA CurrentSince Dec 3, 2021 Accepting new patients
Ascension Medical Group Via Christi, PA Past Accepting new patients

Locations

1640 E Tall Tree Rd
Derby, KS 67037
Phone (316) 274-8222

1100 N Saint Francis Ave
Ste 400
Wichita, KS 67214

3311 E Murdock St
Wichita, KS 67208
Phone (316) 689-9107

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1559088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580342400000",
    "number": "1962060616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 RAINBOW CT",
            "city": "BUHLER",
            "state": "KS",
            "postal_code": "675228076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "651 E PRESCOTT RD",
            "city": "SALINA",
            "state": "KS",
            "postal_code": "674017408",
            "telephone_number": "785-825-7251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRIMMELL",
        "first_name": "MANDY",
        "middle_name": "JO",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-29",
        "last_updated": "2020-01-30",
        "certification_date": "2020-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KS",
            "license": "15-02306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salina, KS

Sources for this page

Verify at the official NPI Registry.