Individual provider Active NPI

Jerilyn Freeman, AGNP-C

  • Nurse Practitioner
  • Liberty, MO
National Provider Identifier
1083003552
Registry record updated Jan 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
2015002153 Issued in MO
Practice address
2525 Glenn Hendren Dr
Liberty, MO 64068-9625
Phone
(816) 781-7200
NPI assigned
Jan 21, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X TEMPAPRN0102 GA
Adult Health Nurse Practitioner 363LA2200X 53-76667-062 KS
Gerontology Nurse Practitioner 363LG0600X 53-76667-062 KS
Nurse Practitioner 363L00000X 2015002153 MO Primary

Addresses

Primary practice location

2525 Glenn Hendren Dr
Liberty, MO 64068-9625

Mailing address

PO Box 219672
Kansas City, MO 64121-9672
Phone (816) 407-4200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, KS2 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
I20150213000771 MO Practitioner - Nurse Practitioner 0648595678 Reassigns benefits to 4 organizations
I20190116001140 KS Practitioner - Nurse Practitioner 0648595678 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Chicago, Pritzker School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New Liberty Hospital CorporationGroup PAC ID 9931166618, 135 clinicians

Practice addresses (Care Compare)

2525 Glenn Hendren Dr
Liberty, MO 64068-9625
Phone (816) 781-7200

Hospital & facility affiliations

  • Liberty Hospital Hospital, Liberty, MO, CCN 260177

Merit-based Incentive Payment System (MIPS)

Final score
81.21 of 100Reported as group
Quality
69.99
Promoting interoperability
99
Improvement activities
40
Cost
68.22

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TEMPAPRN0102GAMDNurse Practitioner
2015002153MOMDNurse Practitioner
53-76667-062KSMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Crossroads Hospice of Kansas City CurrentSince Aug 6, 2017 Accepting new patients
Kansas City Neurology Associates LLC CurrentSince Mar 9, 2015 Accepting new patients
New Liberty Hospital Corporation CurrentSince Mar 15, 2021 Accepting new patients
New Liberty Hospital Corporation Current Accepting new patients
Louay K. Sabih, LLC CurrentSince Nov 27, 2018 Accepting new patients
New Liberty Hospital Coporation CurrentSince Mar 15, 2021 Accepting new patients
Complete Coverage LLC Past Accepting new patients
New Liberty Hospital Coporation Past Accepting new patients
Medical Specialists PA Past Accepting new patients

Locations

10550 Marty St
Ste 201
Overland Park, KS 66212

12100 W 109th St
Shawnee Mission, KS 66210
Phone (913) 469-4210

10500 Quivira Rd
Shawnee Mission, KS 66215
Phone (913) 227-0565

14310 E 42nd St S
Ste 600
Independence, MO 64055
Phone (816) 333-7308

621 Carondelet Dr
Kansas City, MO 64114
Phone (816) 941-1300

2316 E Meyer Blvd
Kansas City, MO 64132
Phone (816) 276-4360

305 S Platte Clay Way
Kearney, MO 64060
Phone (816) 628-4409

2100 SE Blue Pkwy
Lees Summit, MO 64063
Phone (816) 282-5175

2000 SE Blue Pkwy
Ste 270A
Lees Summit, MO 64063
Phone (816) 524-1700

2525 Glenn Hendren Dr
Liberty, MO 64068
Phone (816) 781-7200

2521 Glenn Hendren Dr
Ste 410
Liberty, MO 64068
Phone (816) 415-3437

Organizations & group practices 9

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1421798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611532800000",
    "number": "1083003552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 219672",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641219672",
            "telephone_number": "816-407-4200",
            "fax_number": "816-407-2362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 GLENN HENDREN DR",
            "city": "LIBERTY",
            "state": "MO",
            "postal_code": "640689625",
            "telephone_number": "816-781-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREEMAN",
        "first_name": "JERILYN",
        "credential": "AGNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-21",
        "last_updated": "2021-01-25",
        "certification_date": "2021-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "TEMPAPRN0102",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "KS",
            "license": "53-76667-062",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "KS",
            "license": "53-76667-062",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2015002153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Liberty, MO

Sources for this page

Verify at the official NPI Registry.