Ambria J Petty, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

53-79703-032 Issued in KS

Practice address

19001 E 48TH St S
Independence, MO 64055-6964

Phone

(816) 251-5100

Fax

(816) 795-0144

NPI assigned

Mar 22, 2021

Last updated

Nov 2, 2021By the provider in NPPES

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 KS

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

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lifeworks Integrative Health LLCGroup PAC ID 8224286703, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lifeworks Integrative Health LLC

  • Physical Medicine & Rehabilitation Physician
  • Shawnee, KS
  • NPI 1710257928
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1616371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635811200000",
    "number": "1164008967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22742 MIDLAND DR",
            "city": "SHAWNEE",
            "state": "KS",
            "postal_code": "662263553",
            "telephone_number": "913-441-2293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19001 E 48TH ST S",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640556964",
            "telephone_number": "816-251-5100",
            "fax_number": "816-795-0144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTY",
        "first_name": "AMBRIA",
        "middle_name": "J",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-22",
        "last_updated": "2021-11-02",
        "certification_date": "2021-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "53-79703-032",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2020032346",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Michelle Perrett, CRNA
• Darren Perry, DDS
• Peter J Muelleman (Affiliated Dermatology and Skin Cancer Clinics)
• Meredith Joyce Peterman
• Ben Peterson, MSPT
• Thuylinh Ngoc Pham, MD
• Sonny Thanh Phan, CRNA
• Lucas Ryan Philipp, MD
• Alexandra E Phillips, LMSW
• Callie Phillips

• Family Nurse Practitioner in Independence, MO
• Providers in Independence, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2021; 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.