Syreeta Lynn Van Ross

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2015039584 Issued in MO

Practice address

16659 E 23Rd St S
Independence, MO 64055-1922

Phone

(816) 631-1885

NPI assigned

Mar 24, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other identifiers 1

Other names 1

• Syreeta Lynn Dickerson Former name

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

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Oak Street Health Physicians Group of Missouri LLCGroup PAC ID 7315340213, 25 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Centerpoint Medical Center Hospital, Independence, MO, CCN 260095

Merit-based Incentive Payment System (MIPS)

Final score

80.35 of 100Reported as group

Quality

61.06

Promoting interoperability

99

Improvement activities

40

Cost

74.26

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/IAHIDD/Endpoint/IAHIDD

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.

• Oak Street Health Physicians Group of Missouri, LLC

  • Primary Care Clinic/Center
  • Saint Louis, MO
  • NPI 1669041760

  Family

  Medicare reassignment Care Compare group NPD
• Inpatient Consultants of Kansas PA

  • Internal Medicine Physician
  • Saint Louis, MO
  • NPI 1861795635
  Medicare reassignment NPD
• Prime Healthcare Kansas City - Physician Services LLC

  • Family Medicine Physician
  • Kansas City, MO
  • NPI 1427449487
  Medicare reassignment NPD
• Advanced Rehabilitation Care, LLC

  • Physical Medicine & Rehabilitation Physician
  • Chicago, IL
  • NPI 1285942722

  MO

  Medicare reassignment NPD
• Ascentist Physicians Group, LLC

  • Otolaryngology Physician
  • Lees Summit, MO
  • NPI 1649206319
  NPD (past)
• Connectcare Hospitalists, LLC.

  • Hospitalist Physician
  • Kansas City, MO
  • NPI 1740718675
  NPD (past)

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

• Centerpoint Medical Center of Independence, LLC

  • General Acute Care Hospital
  • Independence, MO
  • NPI 1942247044
  Care Compare affiliation

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

{
    "created_epoch": "1174694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762732800000",
    "number": "1063539823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 740019",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303740019",
            "telephone_number": "773-644-3941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16659 E 23RD ST S",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640551922",
            "telephone_number": "816-631-1885"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Carondelet Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "MO",
            "postal_code": "641144673",
            "country_code": "US",
            "telephone_number": "816-941-9030",
            "fax_number": "816-941-4416",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAN ROSS",
        "first_name": "SYREETA",
        "middle_name": "LYNN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-24",
        "last_updated": "2025-11-10",
        "certification_date": "2025-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2015039584",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MO",
            "license": "2015039584",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "KS",
            "license": "77550-072",
            "primary": false
        },
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "KS",
            "license": "200380880A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200380880A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SYREETA",
            "last_name": "DICKERSON",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Family Nurse Practitioner in Independence, MO
• Providers in Independence, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2025; 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.