SHELLY C. CRADER (NPI# 1790140150) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790140150 |
| Entity Type | Individual |
| Full Name | SHELLY C. CRADER |
| Other Name | SHELLY C. DARK |
| Credential | APRN |
| Practice Address |
2318 E Central Ave Wichita KS 67214-4436 |
| Practice Telephone | 3162623611 |
| Practice Fax Number | 3162620318 |
| Mailing Telephone | 3162623611 |
| Mailing Fax Number | 3162620318 |
| Enumeration Date | 2015-12-29 |
| Last Update Date | 2015-12-29 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 53-77054 | KS | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2318 E CENTRAL AVE |
| City | WICHITA |
| State | KS |
| Zip Code | 67214-4436 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770574261 | Eleanor Pascual Demoss | Pediatrics | 2318 E Central Ave, Wichita, KS 67214-4436 | 2005-11-02 |
| 1023521671 | Elizabeth J Rempel | Social Worker | 2318 E Central Ave, Wichita, KS 67214-4436 | 2017-11-06 |
| 1275059776 | Gina M Everett | Physician Assistant | 2318 E Central Ave, Wichita, KS 67214-4436 | 2017-08-16 |
| 1891222865 | Jillian Amanda Hulse | Registered Nurse | 2318 E Central Ave, Wichita, KS 67214-4436 | 2017-05-22 |
| 1194251504 | Newman Washington | Counselor | 2318 E Central Ave, Wichita, KS 67214-4436 | 2017-05-04 |
| 1518359439 | Tai Schmotzer | Nurse Practitioner | 2318 E Central Ave, Wichita, KS 67214-4436 | 2015-03-02 |
| 1487056305 | Kelci J Burkey | Physician Assistant | 2318 E Central Ave, Wichita, KS 67214-4436 | 2014-09-23 |
| 1285035022 | Karla S Montelongo | Nurse Practitioner | 2318 E Central Ave, Wichita, KS 67214-4436 | 2014-09-11 |
| 1871901140 | Virginia M Smith | Nurse Practitioner | 2318 E Central Ave, Wichita, KS 67214-4436 | 2014-07-30 |
| 1700228962 | Gregory Neil Platt | Counselor | 2318 E Central Ave, Wichita, KS 67214-4436 | 2013-07-29 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124591185 | Laquita Patrice Boyede | Durable Medical Equipment & Medical Supplies | 1503 Northeast Parkway, Wichita, KS 67214 | 2019-01-02 |
| 1891270674 | Kathryn Denise Boomer | Physician Assistant | 929 St. Francis N, Wichita, KS 67214 | 2018-09-27 |
| 1447756457 | Cardinal Health 132 LLC | Pharmacy | 527 N Grove Street, Suite 100, Wichita, KS 67214 | 2018-03-30 |
| 1023517174 | Laboratory Corporation of America Holdings | Clinical Medical Laboratory | 3243 E Murdock Street, Level G, Wichita, KS 67214 | 2018-02-05 |
| 1558887901 | Shonnetta Lachan Gabriel | Counselor | 2707 E. 21st St. N, Wichita, KS 67214 | 2017-08-17 |
| 1417492174 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 803 N Broadway Ave, Wichita, KS 67214 | 2017-01-04 |
| 1952850653 | Rachel J Johnson | Counselor | 805 N Volutsia, Wichita, KS 67214 | 2016-09-23 |
| 1063899813 | Christy Lee Foos | Social Worker | 2707 E. 21st St. North, Healthcore Clinic, Wichita, KS 67214 | 2015-04-30 |
| 1952708018 | William Schroeder Fargo | Specialist | 701 N. Emporia, Wichita, KS 67214 | 2014-12-04 |
| 1447692710 | Valeriya V Hunter | Dentist | 527 N Grove, Wichita, KS 67214 | 2013-07-26 |
| Find all providers in zip 67214 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497355473 | Judith Anne Shilling | Nurse Practitioner | 362 N Milstead St, Wichita, KS 67212-5428 | 2020-10-28 |
| 1760092894 | Laura Lea Aronis | Nurse Practitioner | 3103 N Sedgwick St, Wichita, KS 67204-4118 | 2020-08-04 |
| 1326663394 | Evolve Diabetes LLC. | Nurse Practitioner | 6805 W Northwind Cir, Wichita, KS 67205-2583 | 2020-06-15 |
| 1619505567 | Brook Moore | Nurse Practitioner | 328 N Mark Allen St, Wichita, KS 67212-5455 | 2020-03-27 |
| 1104483098 | Advanced Infusion and Wellness Center, LLC | Nurse Practitioner | 10333 E 21st St N Ste 106, Wichita, KS 67206-3544 | 2019-05-25 |
| 1861978421 | Celeste Delaine Grothusen | Nurse Practitioner | 3510 N Ridge Rd Ste 100, Wichita, KS 67205-1210 | 2018-07-17 |
| 1235666900 | Amanda A Ewertz | Nurse Practitioner | 3715 N. Oliver St., Wichita, KS 67220 | 2017-05-12 |
| 1851672141 | Keri Dawn Spencer | Nurse Practitioner | Heartland Home Health & Hospice, 2872 N Ridge Road Suite 122, Wichita, KS 67205-1144 | 2011-08-31 |
| 1558657023 | Debbie Dao | Nurse Practitioner | 2622 W Central Ave Ste 101, Wichita, KS 67203-4970 | 2011-06-23 |
| 1942507785 | Jill D. Crotty | Nurse Practitioner | 551 N Hillside St Ste 510, Wichita, KS 67214-4928 | 2011-02-14 |
| Find all providers in WICHITA | ||||
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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.