Individual provider Active NPI

Melinda S Wells, ARNP

  • Nurse Practitioner
  • Olathe, KS
National Provider Identifier
1972586865
Registry record updated Apr 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
53-45053 Issued in KS
Practice address
2090 W Dartmouth St
Olathe, KS 66061-6869
Phone
(913) 856-8300
Fax
(913) 856-8711
NPI assigned
Nov 23, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2020

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 53-45053 KS Primary

Addresses

Primary practice location

2090 W Dartmouth St
Olathe, KS 66061-6869

Mailing address

15607 W 125TH St
Olathe, KS 66062-4991
Phone (785) 483-3333

Other identifiers 1

IdentifierTypeStateIssuer
100643160BMedicaidKS

Other names 1

  • Melinda S Keberlein Former name

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
I20040210000607 KS Practitioner - Nurse Practitioner 9436043502 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
53-45053KSMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Now, LLC CurrentSince Nov 20, 2021 Accepting new patients
Crossroads Hospice of Kansas LLC PastSince Nov 6, 2022 Accepting new patients
West Central Kansas Association, Inc. Past Accepting new patients

Locations

22334 W 66th St
#10
Shawnee, KS 66226
Phone (913) 825-0909

Interoperability endpoints

  • Direct secure messaging: melinda.wells.1@14940.direct.athenahealth.com

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": "1132704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588032000000",
    "number": "1972586865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15607 W 125TH ST",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660624991",
            "telephone_number": "785-483-3333",
            "fax_number": "785-483-4859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2090 W DARTMOUTH ST",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660616869",
            "telephone_number": "913-856-8300",
            "fax_number": "913-856-8711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLS",
        "first_name": "MELINDA",
        "middle_name": "S",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-23",
        "last_updated": "2020-04-28",
        "certification_date": "2020-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KS",
            "license": "53-45053",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100643160B",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELINDA",
            "last_name": "KEBERLEIN",
            "middle_name": "S",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Olathe, KS

Sources for this page

Verify at the official NPI Registry.