Concilia Amaonye I
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Kansas City, KS
NPI 1154736445 · NPPES record last updated Apr 5, 2022
Key facts
- NPI
- 1154736445
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 2021033510 (KS)
- Practice address
- 2205 West 36 Av
Kansas City, KS 66103 - Phone
- (816) 295-1826
- NPI assigned
- Jun 25, 2014
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 6
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MO, KS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220203001772 | MO | Practitioner - Nurse Practitioner | 2769875319 | Reassigns benefits to 3 organizations |
| I20220203002266 | KS | Practitioner - Nurse Practitioner | 2769875319 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2021033510 | KS | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kansas Post Acute Medical Services 1 PA | Current |
Accepting new patients | |
| NV Pacs 2 LLC | Current |
Accepting new patients | |
| Ipc Pac Healthcare Services of Missouri Inc | Current |
Accepting new patients | |
| CS Pacs 3 Midwest LLC | Current |
Accepting new patients | |
| Clinical Associates PA | Current |
Accepting new patients | |
| Mi Pacs 2 PC | Past | Accepting new patients |
Locations
1643 NW 136th Ave
Ste 100
Sunrise, FL 33323
Phone (865) 500-1325
17500 W 119th St
Olathe, KS 66061
Phone (913) 213-1686
8629 Bluejacket St
Overland Park, KS 66214
Phone (913) 677-3553
601 E Main St
Pretty Prairie, KS 67570
Phone (620) 459-6822
800 Chambers Rd
Ferguson, MO 63135
Phone (314) 522-8100
3660 Summit St
Kansas City, MO 64111
Phone (816) 531-1089
1221 S Business Highway 13
Lexington, MO 64067
Phone (660) 259-4695
1600 E Rollins St
Moberly, MO 65270
Phone (660) 263-6887
1210 W Ashland St
Nevada, MO 64772
Phone (417) 667-5064
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 2021033510 | KS | Yes |
Addresses
Primary practice location
2205 West 36 Av
Kansas City, KS 66103
Mailing address
1301 SW Pebble LN
Lees Summit, MO 64082-4418
Phone (816) 295-1826
Other providers in Kansas City, KS
- Nasam Altwal
- Anthony Michael Alvarado
- Alison Lyn Alvord
- Darius Amani
- Mohammad Ameen Amanian
- Amazing Smiles of Kansas City, LLC
- American Current Care of Kansas PA
- American Current Care of Kansas PA
- American Current Care PA
- American Oncology Partners, P.a.
All providers in Kansas City, KS · Psychiatric/Mental Health Nurse Practitioner in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 5, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.