MR. TRAVIS RYAN NICKELSON (NPI# 1780012997) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780012997 |
| Entity Type | Individual |
| Full Name | MR. TRAVIS RYAN NICKELSON |
| Credential | MSN, APRN |
| Practice Address |
5500 E Kellogg Dr Wichita KS 67218-1607 |
| Mailing Address |
13809 W Alderny St Wichita KS 67235-7040 |
| Practice Telephone | 3166852221 |
| Mailing Telephone | 6207277537 |
| Enumeration Date | 2013-10-24 |
| Last Update Date | 2013-10-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
53-76159 | KS | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
5500 E KELLOGG DR |
| City | WICHITA |
| State | KS |
| Zip Code | 67218-1607 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194729673 | Catherine A Toomey | Physician Assistant | 5500 E Kellogg Dr, Wichita, KS 67218-1607 | 2005-06-13 |
| 1225642051 | Mark Clark | Pharmacist | 5500 E Kellogg Dr, Wichita, KS 67218-1607 | 2020-08-31 |
| 1598377483 | Rachel Elaine Donis | Occupational Therapist | 5500 E Kellogg Dr, Wichita, KS 67218-1607 | 2020-08-20 |
| 1164030060 | Jacob Michael Goeser | Optometrist | 5500 E Kellogg Dr, Wichita, KS 67218-1607 | 2020-07-16 |
| 1992329262 | Aimee Boriboun | Pharmacist | 5500 E Kellogg Dr, Wichita, KS 67218-1607 | 2020-06-02 |
| 1760012900 | Lisa Christy | Nurse Practitioner | 5500 E Kellogg Dr, Wichita, KS 67218-1607 | 2020-01-15 |
| 1790324499 | Linda Walim Nola | Pharmacist | 5500 E Kellogg Dr, Wichita, KS 67218-1607 | 2019-12-27 |
| 1164078010 | Daniel Steven Haley | Social Worker | 5500 E Kellogg Dr, Wichita, KS 67218-1607 | 2019-08-16 |
| 1790331783 | Jason Alan Jester | Social Worker | 5500 E Kellogg Dr, Wichita, KS 67218-1607 | 2019-08-15 |
| 1629624770 | Emily Suzanne Stuart | Social Worker | 5500 E Kellogg Dr, Wichita, KS 67218-1607 | 2019-08-14 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114544392 | Diana Ho | Optometrist | 980 Oliver Street, Wichita, KS 67218 | 2020-07-03 |
| 1134773690 | Lily Lopez | Nurse's Aide | 5107 E Kellogg Drive, Wichita, KS 67218 | 2019-08-01 |
| 1750862512 | Kelsi Wenger | Student in an Organized Health Care Education/Training Program | 5500 E Kellog Dr, Wichita, KS 67218 | 2018-08-28 |
| 1770038937 | Hair Replacement Clinic | Specialist | 1815 S Windsor, Wichita, KS 67218 | 2016-08-17 |
| 1457757346 | South Wind Women's Centter, LLC | Clinic/Center | 5701 E Kellogg Drive, Wichita, KS 67218 | 2014-11-05 |
| 1124460787 | Teri Kitchen | Social Worker | 3414 Kinkaid, Wichita, KS 67218 | 2013-07-24 |
| 1053660142 | Glenda Rodgers-lawless, Ph.d., Lcpc, Pa | Community/Behavioral Health | 4601 E Douglas, Wichita, KS 67218 | 2012-09-05 |
| 1649541848 | Stephen Rhinehart | Registered Nurse | 5500 E Kellogg Dr., Wichita, KS 67218 | 2012-01-19 |
| 1457666927 | Recovery Services Council Inc. | Point of Service | 1611 South Rutan, Wichita, KS 67218 | 2010-08-09 |
| 1043535867 | Melissa A Weinley | Respiratory Therapist, Registered | 5500 East Kellog Dr, Wichita, KS 67218 | 2010-04-05 |
| Find all providers in zip 67218 | ||||
| Taxonomy Code | 363LP2300X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508497751 | Alexandria Hames | Nurse Practitioner | 341 S Maybelle Ave, Wichita, KS 67209-1535 | 2020-01-27 |
| 1417276791 | House Call Medical Services | Nurse Practitioner | 5721 N Athenian Ave, Wichita, KS 67204-1844 | 2010-05-25 |
| 1851891352 | Julie Cecile Short | Nurse Practitioner | 7348 W 21st St N Ste 121, Wichita, KS 67205-1765 | 2018-02-20 |
| 1720459662 | Thuy Nguyen | Nurse Practitioner | 2131 N Ridge Rd, Wichita, KS 67212-1570 | 2015-10-19 |
| 1386015550 | New Market Health Care LLC | Nurse Practitioner | 2131 N Ridge Rd, Wichita, KS 67212-1570 | 2015-10-14 |
| 1154702793 | Rickae D Strack | Nurse Practitioner | 2707 E 21st St N, Wichita, KS 67214-2249 | 2015-06-09 |
| 1942634019 | Julie A Weber | Nurse Practitioner | 144 S Hillside St, Wichita, KS 67211-2154 | 2013-08-26 |
| 1225388275 | Debora Ann Brand | Nurse Practitioner | 8533 E 32nd St N, Wichita, KS 67226-2611 | 2012-09-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467804542 | Raechel Marie Mackey | Nurse Practitioner | 4101 S 4th St Bldg 160, Leavenworth, KS 66048 | 2016-07-12 |
| 1770955049 | Leandra Monreal | Nurse Practitioner | 3405 Nw Hunters Ridge Terrace Suite 100, Sunflower Prompt Care, Topeka, KS 66618 | 2015-10-27 |
| 1801268404 | Mh Health of Kansas, Pa | Nurse Practitioner | 1225 S Hamilton Cir, C/o Olathe Employee Health Center, Olathe, KS 66061-5372 | 2015-10-22 |
| 1184037509 | Mh Health of Kansas, Pa | Nurse Practitioner | 8950 Renner Blvd, C/o Perceptive Software Health Center, Lenexa, KS 66219 | 2014-06-03 |
| 1568407674 | Kara D Winkler | Nurse Practitioner | 9710 Rosehill Rd, Lenexa, KS 66215 | 2006-06-20 |
| 1710935721 | Florence Susan George | Nurse Practitioner | 207b E 7th St, Hays, KS 67601-4152 | 2006-05-04 |
| 1760099931 | Brenda Hough | Nurse Practitioner | 636 Tauromee Ave, Kansas City, KS 66101-3042 | 2020-09-30 |
| 1881230118 | Alan Curtis | Nurse Practitioner | 400 W 8th, Surgical Clinic, Beloit, KS 67420-0399 | 2019-11-21 |
| 1407415136 | Jason Buehler | Nurse Practitioner | 6345 Long Ave, Shawnee, KS 66216-2504 | 2019-06-06 |
| 1659843175 | Jordan C Koci | Nurse Practitioner | 2200 Sw Gage Blvd, Topeka, KS 66622-0001 | 2018-12-21 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.