Ami L Koelliker, AGNP-C

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

2019021301 Issued in MO

Practice address

2790 Clay Edwards Dr Ste 520
North Kansas City, MO 64116-3274

Phone

(816) 221-6750

Fax

(816) 221-2335

NPI assigned

Jun 17, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Nurse Practitioner

Education

University of Missouri, Kansas City, School of Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Meritas Health CorporationGroup PAC ID 6305748153, 492 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• NKC Health Hospital, North Kansas City, MO, CCN 260096

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Meritas Health Corporation

  • Family Medicine Physician
  • Kansas City, MO
  • NPI 1801875091
  Medicare reassignment Care Compare group NPD
• Meritas Health Corporation

  • Cardiovascular Disease Physician
  • North Kansas City, MO
  • NPI 1609855899
  NPD
• Meritas Health Corporation

  • Neurology Physician
  • Kansas City, MO
  • NPI 1669323291
  NPD
• Meritas Health Corporation

  • Neurology Physician
  • North Kansas City, MO
  • NPI 1023439833
  NPD (past)
• Meritas Health Corporation

  • Pulmonary Disease Physician
  • North Kansas City, MO
  • NPI 1437596921
  NPD (past)
• Meritas Health Corporation

  • Hospitalist Physician
  • North Kansas City, MO
  • NPI 1497206536
  NPD (past)
• Meritas Health Corporation

  • Family Medicine Physician
  • Kansas City, MO
  • NPI 1619606159
  NPD (past)

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

• North Kansas City Hospital

  • Skilled Nursing Facility
  • North Kansas City, MO
  • NPI 1437103215

  Hospital

  Care Compare affiliation
• North Kansas City Hospital

  • General Acute Care Hospital
  • North Kansas City, MO
  • NPI 1629062799
  Care Compare affiliation

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

{
    "created_epoch": "1560729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560816000000",
    "number": "1144880758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2790 CLAY EDWARDS DR STE 520",
            "city": "NORTH KANSAS CITY",
            "state": "MO",
            "postal_code": "641163274",
            "telephone_number": "816-221-6750",
            "fax_number": "816-221-2335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2790 CLAY EDWARDS DR STE 520",
            "city": "NORTH KANSAS CITY",
            "state": "MO",
            "postal_code": "641163274",
            "telephone_number": "816-221-6750",
            "fax_number": "816-221-2335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOELLIKER",
        "first_name": "AMI",
        "middle_name": "L",
        "credential": "AGNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-17",
        "last_updated": "2019-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MO",
            "license": "2019021301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• King Family Dentistry DDS PC
• Janna Michelle Kittle, PHARMD
• Courtney Renee Klahn, RD, LD
• Cali Knipp, CPHT
• Bailey Marie Knold, RN
• Jenna Koeneman
• Shannon Kohake, MD
• Kendra Korner, RDN, LD
• Steven C Kosa, MD
• Taylor Marie Kraft, M.S. CCC-SLP

• Gerontology Nurse Practitioner in North Kansas City, MO
• Providers in North Kansas City, MO by specialty
• Gerontology Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.