Individual provider Active NPI

Kelsey Wicker, FNP-C

  • Family Nurse Practitioner
  • Kansas City, MO
National Provider Identifier
1134838014
Registry record updated Jan 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2022041283 Issued in MO
Practice address
4400 Broadway Blvd Ste 520
Kansas City, MO 64111-3342
Phone
(816) 960-7600
NPI assigned
Nov 18, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5382735 KS
Family Nurse Practitioner 363LF0000X 2022041283 MO Primary

Addresses

Primary practice location

4400 Broadway Blvd Ste 520
Kansas City, MO 64111-3342

Mailing address

901 E 104TH St
Mailstop 400S
Kansas City, MO 64131
Phone (816) 960-7600

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
I20221228002202 MO Practitioner - Nurse Practitioner 4183094642 Reassigns benefits to 1 organization
I20240207001136 KS Practitioner - Nurse Practitioner 4183094642 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Saint Lukes Physician Group IncGroup PAC ID 3577476894, 1,233 clinicians

Practice addresses (Care Compare)

12330 Metcalf Ave
Suite 400
Overland Park, KS 66213-1307
Phone (816) 932-7900

4400 Broadway
Suite 520
Kansas City, MO 64111-3342
Phone (816) 531-4080

Hospital & facility affiliations

  • Saint Luke'S East Hospital Hospital, Lees Summit, MO, CCN 260216
  • St Lukes Hospital of Kansas City Hospital, Kansas City, MO, CCN 260138
  • Saint Lukes North Hospital Hospital, Kansas City, MO, CCN 260062
  • Saint Luke'S South Hospital Hospital, Overland Park, KS, CCN 170185

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5382735KSMDFamily Nurse Practitioner
2022041283MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Luke'S Physician Group Inc CurrentSince Feb 19, 2024 Accepting new patients

Locations

711 Marshall St
Leavenworth, KS 66048
Phone (913) 684-1100

12330 Metcalf Ave
Ste 400
Overland Park, KS 66213
Phone (913) 317-7990

12330 Metcalf Ave
Ste 500A
Overland Park, KS 66213
Phone (913) 323-9000

901 E 104th St
#400S
Kansas City, MO 64131
Phone (816) 502-7117

5844 NW Barry Rd
Ste 110
Kansas City, MO 64154
Phone (816) 880-6100

4400 Broadway Blvd
Ste 520
Kansas City, MO 64111
Phone (816) 531-4080

601 S US Highway 169
Smithville, MO 64089
Phone (816) 532-3999

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722

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 and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1668729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705968000000",
    "number": "1134838014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 E 104TH ST",
            "address_2": "MAILSTOP 400S",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "64131",
            "telephone_number": "816-960-7600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 BROADWAY BLVD STE 520",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641113342",
            "telephone_number": "816-960-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICKER",
        "first_name": "KELSEY",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-18",
        "last_updated": "2024-01-23",
        "certification_date": "2024-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "5382735",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2022041283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.