Stacey R Bosch

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

53-82585 Issued in KS

Practice address

4300 Brenner Dr
Kansas City, KS 66104-1163

Phone

(913) 322-4900

NPI assigned

Jun 16, 2014

Last updated

Oct 3, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/JIGIBD/Endpoint/JIGIBD

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kansas City Care Clinic

  dba KC CARE Health Center

  • Federally Qualified Health Center (FQHC)
  • Kansas City, MO
  • NPI 1215273388
  Medicare reassignment NPD
• Kansas City Care Clinic

  dba KC CARE Health Center

  • Federally Qualified Health Center (FQHC)
  • Kansas City, MO
  • NPI 1437897774
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1402876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696291200000",
    "number": "1003220245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 SW FRAZIER AVE",
            "city": "TOPEKA",
            "state": "KS",
            "postal_code": "666061963",
            "telephone_number": "785-232-5005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 BRENNER DR",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661041163",
            "telephone_number": "913-322-4900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSCH",
        "first_name": "STACEY",
        "middle_name": "R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-16",
        "last_updated": "2023-10-03",
        "certification_date": "2023-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KS",
            "license": "53-82585",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Raveena Saraswathi Boodram
• Kanachai Boonpiraks, M.D.
• Jeffrey L. Borders, MD
• Steven William Bormann, M.D.
• Sydney L Bormann, MD
• Madisen Boskind, MD
• Damieon Boswell
• Christopher Bouton, DPT
• Morgan Rae Bowden, PA-C
• Marvin Bowens Sr., LAC

• Psychiatric/Mental Health Nurse Practitioner in Kansas City, KS
• Providers in Kansas City, KS by specialty
• Psychiatric/Mental Health Nurse Practitioner in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.