MEDICARE: FIDELITY TOTAL HEALTHCARE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1235086000
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FIDELITY TOTAL HEALTHCARE

Provider Business Mailing Address
First Line	:	401 S CLAIRBORNE RD STE 303
Second Line	:
City	:	OLATHE
State	:	KS
Zip	:	66062-1735
Country	:	US
Telephone Number	:	913-244-7319
Fax Number	:	913-543-4444

Provider Business Practice Location Address
First Line	:	401 S CLAIRBORNE RD STE 303
Second Line	:
City	:	OLATHE
State	:	KS
Zip	:	66062-1735
Country	:	US
Telephone Number	:	913-244-7319
Fax Number	:	913-543-4444

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	NEEMA TITUS MSHANA
Credential	:
Telephone Number	:	913-602-0622

Provider Enumeration Date	:	03/11/2026
Last Update Date	:	03/27/2026

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