Individual provider Active NPI

Roseann Marie Ecklund, R.N.

  • Critical Care Medicine Registered Nurse
  • Lees Summit, MO
National Provider Identifier
1023255569
Registry record updated Jan 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine Registered NurseTaxonomy code 163WC0200X
License
084800 Issued in MO
Practice address
912 NE Kenwood Dr
Lees Summit, MO 64064-1761
Phone
(816) 503-9827
NPI assigned
Jan 20, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 20, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X 084800 MO Primary

Addresses

Primary practice location

912 NE Kenwood Dr
Lees Summit, MO 64064-1761

Mailing address

912 NE Kenwood Dr
Lees Summit, MO 64064-1761
Phone (816) 503-9827

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
084800MOMDCritical Care Medicine Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1232409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232409600000",
    "number": "1023255569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "912 NE KENWOOD DR",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640641761",
            "telephone_number": "816-503-9827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "912 NE KENWOOD DR",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640641761",
            "telephone_number": "816-503-9827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ECKLUND",
        "first_name": "ROSEANN",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "R.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-20",
        "last_updated": "2009-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "MO",
            "license": "084800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lees Summit, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2009; 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.