Michelle L Roach, CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

121088 Issued in MO

Practice address

2401 Gillham Rd
Kansas City, MO 64108-4619

Phone

(816) 234-3080

Fax

(816) 983-6633

NPI assigned

Jul 7, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Certified Pediatric Nurse Practitioner, Nurse Practitioner

State licenses

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1293062400000",
    "number": "1013915727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 GILLHAM RD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641084619",
            "telephone_number": "816-234-3080",
            "fax_number": "816-983-6633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 GILLHAM RD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641084619",
            "telephone_number": "816-234-3080",
            "fax_number": "816-983-6633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROACH",
        "first_name": "MICHELLE",
        "middle_name": "L",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-07",
        "last_updated": "2010-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MO",
            "license": "121088",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FAMILY HEALTH PARTNERS",
            "identifier": "073571",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "428512339",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• RMC HBP LLC (RMC Medical Oncologists)
• RMC HBP, LLC (RMC Trauma Services)
• RMC HBP, LLC (dba: RMC Pulmonary Physicians)
• RMC Transplant Physicians LLC
• Larry Ro-Trock, PHD
• Raven Pearl Roach, RN
• Eric Neil Roadman, O.D.
• Rachelle Leigh Roark
• Zachary Roark, RN
• Harold Robaina

• Pediatric Nurse Practitioner in Kansas City, MO
• Providers in Kansas City, MO by specialty
• Pediatric Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.