Individual provider Active NPI

Alexandra Lee

  • Family Nurse Practitioner
  • Overland Park, KS
National Provider Identifier
1003372327
Registry record updated Apr 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5379552 Issued in KS
Practice address
14205 Metcalf Ave
Overland Park, KS 66223-3367
Phone
(913) 620-1616
Fax
(913) 624-3848
NPI assigned
Feb 11, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5379552 KS Primary

Addresses

Primary practice location

14205 Metcalf Ave
Overland Park, KS 66223-3367

Mailing address

4412 W 70TH St
Prairie Village, KS 66208-2552

Other practice location 1

4412 W 70th St
Prairie Village, KS 66208-2552
Phone (913) 709-4719

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211102003224 KS Order and Referring Only - Family PracticePractitioner - Family Practice 1658769120

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5379552KSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Heartland Weight Loss CurrentSince Apr 10, 2022 Accepting new patients
Heartland Surgical Care LLC PastSince Apr 10, 2022 Accepting new patients

Locations

14205 Metcalf Ave
Overland Park, KS 66223
Phone (913) 620-1616

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1549843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649116800000",
    "number": "1003372327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4412 W 70TH ST",
            "city": "PRAIRIE VILLAGE",
            "state": "KS",
            "postal_code": "662082552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14205 METCALF AVE",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662233367",
            "telephone_number": "913-620-1616",
            "fax_number": "913-624-3848"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4412 W 70th St",
            "address_purpose": "LOCATION",
            "city": "Prairie Village",
            "state": "KS",
            "postal_code": "662082552",
            "country_code": "US",
            "telephone_number": "913-709-4719",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "ALEXANDRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-11",
        "last_updated": "2022-04-05",
        "certification_date": "2022-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "5379552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

Verify at the official NPI Registry.