Individual provider Active NPI

Sarah M Johnson

  • Nurse Practitioner
  • Wichita, KS
National Provider Identifier
1972916773
Registry record updated May 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
53-76337-081 Issued in KS
Practice address
1911 N Webb Rd
Wichita, KS 67206
Phone
(316) 682-7546
Fax
(316) 682-7554
NPI assigned
Jun 9, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP60316269 WA
Family Nurse Practitioner 363LF0000X 201250188NP OR
Nurse Practitioner 363L00000X 53-76337-081 KS Primary

Addresses

Primary practice location

1911 N Webb Rd
Wichita, KS 67206

Mailing address

1911 N Webb Rd
Wichita, KS 67206-3405
Phone (316) 682-7546

Other identifiers 1

IdentifierTypeStateIssuer
12705301OtherCAQH

Other names 1

  • Sarah M Zielke 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
I20140804000930 KS Practitioner - Nurse Practitioner 0244457950 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Forefront Dermatology - Kansas, PAGroup PAC ID 3274008016, 7 clinicians
Wichita Dermatology LLCGroup PAC ID 7315360716, 7 clinicians

Practice addresses (Care Compare)

1911 N Webb Rd
Wichita, KS 67206-3405
Phone (316) 682-7546

Merit-based Incentive Payment System (MIPS)

Final score
91.13 of 100Reported as group
Quality
89.77
Improvement activities
40
Cost
84.07

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
53-76337-081KSMDNurse Practitioner
201250188NPORMDFamily Nurse Practitioner
AP60316269WAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wichita Dermatology LLC Moeller Dermatology CurrentSince Jul 13, 2020 Accepting new patients

Locations

1911 N Webb Rd
Wichita, KS 67206
Phone (316) 682-7546

4013 N Ridge Rd
Ste 120
Wichita, KS 67205
Phone (316) 682-7546

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": "1402272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527033600000",
    "number": "1972916773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1911 N WEBB RD",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672063405",
            "telephone_number": "316-682-7546",
            "fax_number": "316-682-7554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1911 N WEBB RD",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "67206",
            "telephone_number": "316-682-7546",
            "fax_number": "316-682-7554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SARAH",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-09",
        "last_updated": "2018-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP60316269",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "201250188NP",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KS",
            "license": "53-76337-081",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12705301",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SARAH",
            "last_name": "ZIELKE",
            "middle_name": "M",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.