Jennifer Utterback, APRN-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2013032468 Issued in MO

Practice address

20 NW R.D. Mize Road
Emergency Department
Blue Springs, MO 64014-4411

Phone

(816) 655-5472

NPI assigned

Sep 19, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO, NM2 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

Specialty

Nurse Practitioner

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Emergency Medicine Services of Mo LLCGroup PAC ID 1951766559, 85 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint Luke's South Hospital Hospital, Overland Park, KS, CCN 170185
• Saint Luke's East Hospital Hospital, Lees Summit, MO, CCN 260216

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 and National Provider Directory roles.

• Emergency Medicine Services of Mo, LLC

  • Emergency Medicine Physician
  • Independence, MO
  • NPI 1023715182
  Medicare reassignment Care Compare group NPD
• Rehoboth McKinley Christian Health Care Services, Inc

  • Critical Access Hospital
  • Gallup, NM
  • NPI 1689784506
  Medicare reassignment NPD
• VA Eastern Kansas Health Care System

  • Emergency Medicine Physician
  • Leavenworth, KS
  • NPI 1255432951

  MO

  Medicare reassignment NPD
• Rehoboth McKinley Christian Health Care Services, Inc

  • Rural Health Clinic/Center
  • Gallup, NM
  • NPI 1689779860
  NPD
• Rehoboth McKinley Christian Health Care Services, Inc.

  dba RMCHCS Hospital

  • Critical Access Hospital
  • Gallup, NM
  • NPI 1720084999
  NPD

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

• Saint Lukes East Hospital

  dba Saint Luke's East Lee's Summit Hospital

  • General Acute Care Hospital
  • Lee's Summit, MO
  • NPI 1053353490
  Care Compare affiliation
• Saint Lukes South Hospital, Inc.

  • General Acute Care Hospital
  • Overland Park, KS
  • NPI 1154303337
  Care Compare affiliation

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

{
    "created_epoch": "1379548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666051200000",
    "number": "1174959365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 NW R D MIZE RD",
            "address_2": "EMERGENCY DEPARTMENT",
            "city": "BLUE SPRINGS",
            "state": "MO",
            "postal_code": "640142513",
            "telephone_number": "816-655-5472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 NW R.D. MIZE ROAD",
            "address_2": "EMERGENCY DEPARTMENT",
            "city": "BLUE SPRINGS",
            "state": "MO",
            "postal_code": "640144411",
            "telephone_number": "816-655-5472"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1901 Red Rock Dr",
            "address_purpose": "LOCATION",
            "city": "Gallup",
            "state": "NM",
            "postal_code": "873015683",
            "country_code": "US",
            "telephone_number": "505-863-7393",
            "fax_number": "660-862-7330",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "403 Burkarth Rd",
            "address_purpose": "LOCATION",
            "city": "Warrensburg",
            "state": "MO",
            "postal_code": "640933101",
            "country_code": "US",
            "telephone_number": "660-626-7301",
            "fax_number": "660-626-7725",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8010 State Line Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Prairie Village",
            "state": "KS",
            "postal_code": "662083711",
            "country_code": "US",
            "telephone_number": "816-830-4285",
            "fax_number": "913-400-3631",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "UTTERBACK",
        "first_name": "JENNIFER",
        "credential": "APRN-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-19",
        "last_updated": "2022-10-18",
        "certification_date": "2022-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "65688",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "53-79796-122",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2013032468",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1174959365",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Blue Springs, MO
• Providers in Blue Springs, 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 Oct 18, 2022; 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.