MRS. TINA M SHOLL (NPI# 1922007020) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922007020 |
| Entity Type | Individual |
| Full Name | MRS. TINA M SHOLL |
| Credential | ARNP |
| Practice Address |
4013 N Ridge Rd Ste 110 Wichita KS 67205-8857 |
| Mailing Address |
4013 N Ridge Rd Ste 110 Wichita KS 67205-8857 |
| Practice Telephone | 3167221333 |
| Practice Fax Number | 3167223058 |
| Mailing Telephone | 3167221333 |
| Mailing Fax Number | 3167223058 |
| Enumeration Date | 2005-07-20 |
| Last Update Date | 2010-09-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LC0200X |
Nurse Practitioner Specialization: Critical Care Medicine |
45445 | KS | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KS | 200002810A | 05 | |
| KS | MEDICARE PTAN | KA1634002 | 01 |
| Street Address |
4013 N RIDGE RD STE 110 |
| City | WICHITA |
| State | KS |
| Zip Code | 67205-8857 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356340178 | Jerry G Gaston | Surgery | 4013 N Ridge Rd, Ste 210, Wichita, KS 67205-8860 | 2005-07-14 |
| 1619235819 | Jeanne Lynn Pearson | Nurse Practitioner | 4013 N Ridge Rd, Suite 110, Wichita, KS 67205-8857 | 2012-04-25 |
| 1063707438 | Adam P Misasi | Surgery | 4013 N Ridge Rd, Ste. 210, Wichita, KS 67205-8857 | 2011-06-14 |
| 1033351903 | Kansas Surgical Arts LLC | Surgery | 4013 N Ridge Rd, Ste 110, Wichita, KS 67205-8857 | 2009-03-24 |
| 1487679759 | Stephen A. Olson | Surgery | 4013 N Ridge Rd, Ste. 210, Wichita, KS 67205-8857 | 2006-07-13 |
| 1275560336 | Erica C Hickerson | Physician Assistant | 4013 N Ridge Rd, Suite 110, Wichita, KS 67205-8857 | 2006-06-26 |
| 1386613107 | Surgical Specialists Pa | Surgery | 4013 N Ridge Rd, Ste 210, Wichita, KS 67205-8860 | 2006-03-15 |
| 1902805674 | John P Smith | Surgery | 4013 N Ridge Rd, Ste 210, Wichita, KS 67205-8860 | 2005-07-15 |
| 1396744116 | Jill M Smith | Nurse Practitioner | 4013 N Ridge Rd, Ste 210, Wichita, KS 67205-8860 | 2005-07-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295211910 | Emily M Chastain | Dentist | 3213 N. Ridge Rd, Wichita, KS 67205 | 2018-07-16 |
| 1811415466 | Awaken Psychology LLC | Clinic/Center | 2552 N Maize Ct Suite 600, Wichita, KS 67205 | 2017-09-05 |
| 1962940288 | Moc Wichita LLC | Assisted Living Facility | 7057 W Village Circle, Wichita, KS 67205 | 2017-02-07 |
| 1003362732 | Moc Wichita, LLC | Assisted Living Facility | 7057 West Village Circle, Wichita, KS 67205 | 2016-09-01 |
| 1649637653 | Abigail Friend | Audiologist-Hearing Aid Fitter | 2558 Lake Way Circle, Wichita, KS 67205 | 2016-01-21 |
| 1134505399 | Myles Davidson | Dentist | 3510 N Ridge Rd Ste 500, Wichita, KS 67205 | 2015-08-10 |
| 1093121097 | The Eye Gallery, LLC | Optometrist | 3084 N. Maize Rd, Wichita, KS 67205 | 2014-07-10 |
| 1922428721 | Sam's West, Inc. | Technician/Technologist | 3084 N. Maize Road, Witchita, KS 67205 | 2014-04-18 |
| 1447693627 | Caryn Rana Landreth | Social Worker | 3114 N Brush Creek St, Wichita, KS 67205 | 2013-04-08 |
| 1902182686 | Return To Motion Medical | Durable Medical Equipment & Medical Supplies | 3221 N Ridge Port Circle, Wichita, KS 67205 | 2011-10-26 |
| Find all providers in zip 67205 | ||||
| Taxonomy Code | 363LC0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Critical Care Medicine |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184026858 | Ashley Celis | Nurse Practitioner | 12200 W 106th St Ste 235, Overland Park, KS 66215-2368 | 2014-09-24 |
| 1023119765 | Debra L Rezac | Nurse Practitioner | 114 West 8th Street, Onaga, KS 66521-9547 | 2006-09-26 |
| 1699316687 | Jessica Lerner | Nurse Practitioner | 4000 Cambridge St, Kansas City, KS 66160-8501 | 2019-10-01 |
| 1629536974 | Samuel Rivera Ortiz | Nurse Practitioner | 4000 Cambridge St, Kansas City, KS 66160-8501 | 2019-03-06 |
| 1508236365 | Charis Grosdidier | Nurse Practitioner | 3901 Rainbow Blvd, Kansas City, KS 66160-8500 | 2015-10-05 |
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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.