Individual provider Active NPI

Gregory Nurrenbern, NP

  • Family Nurse Practitioner
  • Kansas City, MO
National Provider Identifier
1124390620
Registry record updated Oct 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2012003063 Issued in MO
Practice address
825 Euclid Ave
Kansas City, MO 64124-2323
Phone
(816) 889-4730
Fax
(816) 889-1847
NPI assigned
Jan 31, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2012003063 MO Primary

Addresses

Primary practice location

825 Euclid Ave
Kansas City, MO 64124-2323

Mailing address

825 Euclid Ave
Kansas City, MO 64124-2323
Phone (816) 889-4730

Other identifiers 2

IdentifierTypeStateIssuer
1124390620MedicaidMO
2012003063OtherMOLICENSE

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20120315000643 MO Practitioner - Nurse Practitioner 1850550526 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Samuel U Rodgers Health Center IncGroup PAC ID 9739092826, 28 clinicians

Practice addresses (Care Compare)

825 Euclid Ave
Kansas City, MO 64124-2323
Phone (816) 474-4920

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2012003063MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Samuel U. Rodgers Health Center, Inc. CurrentSince Aug 20, 2012 Accepting new patients
Samuel U. Rodgers Health Center, Inc CurrentSince Aug 20, 2012 Accepting new patients
Cabot Westside Health Center Past Accepting new patients

Locations

2121 Summit St
Kansas City, MO 64108
Phone (816) 471-0900

5330 N Oak Trfy
Ste 104
Kansas City, MO 64118
Phone (816) 455-7471

825 Euclid Ave
Kansas City, MO 64124
Phone (816) 889-4816

811 S Business Highway 13
Ste A
Lexington, MO 64067
Phone (660) 259-3823

800 Haines
Liberty, MO 64068
Phone (816) 595-4200

Interoperability endpoints

  • Direct secure messaging: gregory.nurrenbern.p1@direct.rodgershealth.nextgenshare.com

Organizations & group practices 3

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": "1327968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476230400000",
    "number": "1124390620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 EUCLID AVE",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641242323",
            "telephone_number": "816-889-4730",
            "fax_number": "816-889-1847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 EUCLID AVE",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641242323",
            "telephone_number": "816-889-4730",
            "fax_number": "816-889-1847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NURRENBERN",
        "first_name": "GREGORY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-01-31",
        "last_updated": "2016-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2012003063",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1124390620",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "2012003063",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.