Carly Payne, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2020027179 Issued in MO

Practice address

2861 NE Independence Ave Ste 201
Lees Summit, MO 64064-2379

Phone

(816) 525-2840

Fax

(816) 525-2841

NPI assigned

Jul 1, 2020

Last updated

Jun 18, 2024By 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 KS, MO2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advanced Orthopedics and Sports MedicineGroup PAC ID 8820370422, 45 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lee's Summit Medical Center Hospital, Lees Summit, MO, CCN 260190
• Saint Luke's South Hospital Hospital, Overland Park, KS, CCN 170185
• Adventhealth South Overland Park, Inc Hospital, Overland Park, KS, CCN 170208
• Centerpoint Medical Center Hospital, Independence, MO, CCN 260095
• Saint Luke's East Hospital Hospital, Lees Summit, MO, CCN 260216

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Advanced Orthopedics and Sports Medicine

  dba Sano Orthopedics

  • Orthopaedic Surgery Physician
  • Lee's Summit, MO
  • NPI 1003268087

  KS

  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Centerpoint Medical Center of Independence, LLC

  dba Centerpoint Medical Center

  • General Acute Care Hospital
  • Independence, MO
  • NPI 1942247044
  Care Compare affiliation
• Midwest Division - LSH, LLC

  dba Lee's Summit Medical Center

  • General Acute Care Hospital
  • Lee's Summit, MO
  • NPI 1225085871
  Care Compare affiliation
• Saint Lukes East Hospital

  dba Saint Luke's East Lee's Summit Hospital

  • General Acute Care Hospital
  • Lee's Summit, MO
  • NPI 1053353490
  Care Compare affiliation
• Adventhealth South Overland Park, Inc.

  dba AdventHealth South Overland Park

  • General Acute Care Hospital
  • Overland Park, KS
  • NPI 1316536253
  Care Compare affiliation
• Saint Lukes South Hospital, Inc.

  • General Acute Care Hospital
  • Overland Park, KS
  • NPI 1154303337
  Care Compare affiliation

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

{
    "created_epoch": "1593561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718668800000",
    "number": "1023635380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2861 NE INDEPENDENCE AVE STE 201",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640642379",
            "telephone_number": "816-525-2840",
            "fax_number": "816-525-2841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2861 NE INDEPENDENCE AVE STE 201",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640642379",
            "telephone_number": "816-525-2840",
            "fax_number": "816-525-2841"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11340 Nall Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Overland Park",
            "state": "KS",
            "postal_code": "662111234",
            "country_code": "US",
            "telephone_number": "816-525-2840",
            "fax_number": "816-525-2841",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAYNE",
        "first_name": "CARLY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-01",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KS",
            "license": "1502351",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2020027179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jina L. Patton, ACNP-PP
• Paul T. Matlock, DDS PC
• Adam Paul
• Kate Marie Pavlica, LPC
• Andrew Sinclair Pavlovich, M.D.
• Edith A Payne, CRNA
• Reilynn Payne
• Sarah Ann Payne, AGACNP-BC
• Sarah Pearl, D.O.
• Carla R Pearman, M.D.

• Physician Assistant in Lee's Summit, MO
• Providers in Lee's Summit, MO by specialty
• Physician Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.