Individual provider Active NPI

Jennifer Anne Kush, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Liberty, MO
National Provider Identifier
1144874769
Registry record updated Dec 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2019038966 Issued in MO
Practice address
1901 W Kansas St
Liberty, MO 64068-2060
Phone
(816) 781-0035
NPI assigned
Jul 31, 2019
Last updated
Dec 9, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2025

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 2019038966 MO Primary
Registered Nurse 163W00000X 2002018650 MO

Addresses

Primary practice location

1901 W Kansas St
Liberty, MO 64068-2060

Mailing address

1901 W Kansas St
Liberty, MO 64068-2060
Phone (816) 394-0144

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
I20200110001301 MO Practitioner - Nurse Practitioner 1052746583 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Minuteclinic Diagnostic of Kansas PAGroup PAC ID 7416043807, 139 clinicians

Practice addresses (Care Compare)

13101 State Line Rd
Kansas City, MO 64145-1650
Phone (866) 389-2727

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2002018650MOMDRegistered Nurse
2019038966MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic Diagnostic of Kansas PA Family CurrentSince Aug 25, 2020 Accepting new patients
Excelsior Springs Physician Clinic LLC Past Accepting new patients

Locations

3825 S Noland Rd
Independence, MO 64055
Phone (816) 254-6002

13101 State Line Rd
Kansas City, MO 64145
Phone (816) 942-2438

1901 W Kansas St
Liberty, MO 64068
Phone (816) 781-0035

8021 Watson Rd
Webster Groves, MO 63119
Phone (314) 963-0398

Networks

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

Organizations & group practices 2

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": "1564531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765238400000",
    "number": "1144874769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 W KANSAS ST",
            "city": "LIBERTY",
            "state": "MO",
            "postal_code": "640682060",
            "telephone_number": "816-394-0144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 W KANSAS ST",
            "city": "LIBERTY",
            "state": "MO",
            "postal_code": "640682060",
            "telephone_number": "816-781-0035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUSH",
        "first_name": "JENNIFER",
        "middle_name": "ANNE",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-31",
        "last_updated": "2025-12-09",
        "certification_date": "2025-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2019038966",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "2002018650",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Liberty, MO

Sources for this page

Verify at the official NPI Registry.