Individual provider Active NPI

Juanita Elise Monroe, R.N.

  • Home Health Registered Nurse
  • Liberal, KS
National Provider Identifier
1104264803
Registry record updated Jun 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health Registered NurseTaxonomy code 163WH0200X
License
A-088-007 Issued in KS
Practice address
515 4TH St
Liberal, KS 67901
Phone
(580) 461-6127
NPI assigned
Jun 5, 2013
Last updated
Jun 5, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 5, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Registered Nurse 163WH0200X A-088-007 KS Primary

Addresses

Primary practice location

515 4TH St
Liberal, KS 67901

Mailing address

PO Box 1694
Liberal, KS 67905-1694
Phone (580) 461-6127

Other identifiers 1

IdentifierTypeStateIssuer
163WHO200XMedicaidKS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
A-088-007KSMDHome Health Registered Nurse

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1370390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370390400000",
    "number": "1104264803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1694",
            "city": "LIBERAL",
            "state": "KS",
            "postal_code": "679051694",
            "telephone_number": "580-461-6127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 4TH ST",
            "city": "LIBERAL",
            "state": "KS",
            "postal_code": "67901",
            "telephone_number": "580-461-6127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONROE",
        "first_name": "JUANITA",
        "middle_name": "ELISE",
        "credential": "R.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-05",
        "last_updated": "2013-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "KS",
            "license": "A-088-007",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "163WHO200X",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Liberal, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.