Individual provider Active NPI

Kristen R Nondorf, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Lees Summit, MO
National Provider Identifier
1013737121
Registry record updated Dec 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2025024793 Issued in MO
Practice address
2100 SE Blue Pkwy
Lees Summit, MO 64063-1007
Phone
(816) 282-5000
NPI assigned
Oct 14, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2025024793 MO Primary

Addresses

Primary practice location

2100 SE Blue Pkwy
Lees Summit, MO 64063-1007

Mailing address

2100 SE Blue Pkwy
Lees Summit, MO 64063-1007
Phone (816) 282-5000

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20251224000444 MO Practitioner - Physician Assistant 2769977065 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Medicine Services of Mo LLCGroup PAC ID 1951766559, 85 clinicians

Practice addresses (Care Compare)

2100 SE Blue Pkwy
Lee'S Summit Medical Center
Lee'S Summit, MO 64063-1007
Phone (816) 282-5000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2025024793MOMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Services of Mo, LLC CurrentSince Oct 1, 2025 Accepting new patients

Locations

19600 E 39th St S
Independence, MO 64057
Phone (816) 698-7000

2100 SE Blue Pkwy
Lees Summit, MO 64063
Phone (816) 282-5175

403 Burkarth Rd
Warrensburg, MO 64093
Phone (660) 474-2500

Organizations & group practices 1

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": "1728864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766966400000",
    "number": "1013737121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 SE BLUE PKWY",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640631007",
            "telephone_number": "816-282-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 SE BLUE PKWY",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640631007",
            "telephone_number": "816-282-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NONDORF",
        "first_name": "KRISTEN",
        "middle_name": "R",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-14",
        "last_updated": "2025-12-29",
        "certification_date": "2025-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2025024793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lees Summit, MO

Sources for this page

Verify at the official NPI Registry.