Madison Faddis, DNP, FNP-C
Individual provider Active NPI Family Nurse Practitioner · Overland Park, KS
NPI 1073397907 · NPPES record last updated Oct 23, 2024
Key facts
- NPI
- 1073397907
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 53-83293-121 (KS)
- Practice address
- 8505 College Blvd
Overland Park, KS 66210-1836 - Phone
- (913) 541-3230
- NPI assigned
- Aug 22, 2023
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- University of Kansas School of Med (KC/Wich/Sal), 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Epiphany Dermatology of Kansas LLC
Practice addresses (Care Compare)
8505 College Blvd
Overland Park, KS 66210-1836
Phone (913) 541-3230
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240627001395 | KS | Practitioner - Nurse Practitioner | 8527502806 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14-145718-121 | KS | MD | Registered Nurse |
| 53-83293-121 | KS | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Epiphany Dermatology of Kansas, LLC | Dermatology | Current |
Accepting new patients |
| Kansas City Dermatology, P.a. | Current | Accepting new patients | |
| Pediatric Dermatology of Kansas City | Past | Accepting new patients |
Locations
8505 College Blvd
Overland Park, KS 66210
Phone (913) 541-3230
7300 Ranch Road 2222
Bldg 1
Austin, TX 78730
Interoperability endpoints
- https://fhir-myrecord.cerner.com/r4/ab187e7e-b787-4906-b2dc-f4d9812dae4b/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 53-83293-121 | KS | |
| Family Nurse Practitioner | 363LF0000X | 53-83293-121 | KS | Yes |
| Registered Nurse | 163W00000X | 14-145718-121 | KS |
Addresses
Primary practice location
8505 College Blvd
Overland Park, KS 66210-1836
Mailing address
8505 College Blvd
Overland Park, KS 66210-1836
Other providers in Overland Park, KS
- Susanne Kohn Eyman
- Ez Nutrition 4U, LLC
- Anuli Eze
- Joshua E Ezell
- Tiffany Ezell
- Thomas Howard Faerber
- Shelby Lee Fagan Abreu
- Genevieve Faherty
- Chelsea Fair
- Amanda Fairbanks
All providers in Overland Park, KS · Family Nurse Practitioner in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 23, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.