Individual provider Active NPI

Mary Katherine Eikermann, APRN

  • Acute Care Nurse Practitioner
  • Blue Springs, MO
National Provider Identifier
1053947549
Registry record updated Jan 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
2019038327 Issued in MO
Practice address
600 NE Adams Dairy Pkwy
Blue Springs, MO 64014-5493
Phone
(816) 932-4630
Fax
(816) 932-4631
NPI assigned
Mar 17, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 5, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LA2100X 2019038327 MO Primary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X 2019038328 MO
Acute Care Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LA2100X 5378984012 KS
Adult Health Nurse Practitioner 363LA2200X 2019038327 MO

Addresses

Primary practice location

600 NE Adams Dairy Pkwy
Blue Springs, MO 64014-5493

Mailing address

600 NE Adams Dairy Pkwy
Blue Springs, MO 64014-5493
Phone (816) 932-4630

Other names 1

  • Mary Katherine Ismert Former name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20200504000706 KS Practitioner - Nurse Practitioner 3678904802 Reassigns benefits to 1 organization
I20240110000827 MO Practitioner - Nurse Practitioner 3678904802 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Lukes Physician Group IncGroup PAC ID 3577476894, 1,233 clinicians

Practice addresses (Care Compare)

4061 Indian Creek Pkwy
Overland Park, KS 66207-4030
Phone (816) 932-4630

600 NE Adams Dairy Pkwy
Blue Springs, MO 64014-5493
Phone (816) 932-4630

Merit-based Incentive Payment System (MIPS)

Final score
82.56 of 100Reported as group
Quality
76.07
Promoting interoperability
100
Improvement activities
40
Cost
65.79

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5378984012KSMDAcute Care Nurse Practitioner
2019038328MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Luke'S Physician Group Inc Multi-Specialty CurrentSince Feb 12, 2024 Accepting new patients
Saint Luke'S Physician Group Inc CurrentSince Feb 12, 2024 Accepting new patients

Locations

711 Marshall St
Leavenworth, KS 66048
Phone (913) 684-1100

4061 Indian Creek Pkwy
Overland Park, KS 66207
Phone (913) 323-4600

12330 Metcalf Ave
Ste 500A
Overland Park, KS 66213
Phone (913) 323-9000

901 E 104th St
Ste 400
Kansas City, MO 64131
Phone (816) 502-8752

601 S US Highway 169
Smithville, MO 64089
Phone (816) 532-3999

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": "1584403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704412800000",
    "number": "1053947549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 NE ADAMS DAIRY PKWY",
            "city": "BLUE SPRINGS",
            "state": "MO",
            "postal_code": "640145493",
            "telephone_number": "816-932-4630",
            "fax_number": "816-932-4631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 NE ADAMS DAIRY PKWY",
            "city": "BLUE SPRINGS",
            "state": "MO",
            "postal_code": "640145493",
            "telephone_number": "816-932-4630",
            "fax_number": "816-932-4631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EIKERMANN",
        "first_name": "MARY",
        "middle_name": "KATHERINE",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-17",
        "last_updated": "2024-01-05",
        "certification_date": "2024-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MO",
            "license": "2019038327",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2019038328",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "KS",
            "license": "5378984012",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MO",
            "license": "2019038327",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "ISMERT",
            "middle_name": "KATHERINE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Blue Springs, MO

Sources for this page

Verify at the official NPI Registry.