Individual provider Active NPI

Christopher Pelton, FNP-C

  • Family Nurse Practitioner
  • Lee's Summit, MO
National Provider Identifier
1184016529
Registry record updated Jan 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
53-76641-082 Issued in KS
Practice address
506 NW Murray Rd
Lees Summit, MO 64081-1428
Phone
(816) 525-4400
NPI assigned
Feb 23, 2015
Last updated
Jan 4, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2022

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 2015001951 MO
Family Nurse Practitioner 363LF0000X 53-76641-082 KS Primary

Addresses

Primary practice location

506 NW Murray Rd
Lees Summit, MO 64081-1428

Mailing address

12140 Nall Ave Ste 100
Overland Park, KS 66209-2504
Phone (816) 943-0706

Other practice location 1

12140 Nall Ave Ste 100
Overland Park, KS 66209-2504
Phone (816) 943-0706

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address CHRISTOPHER.PELTON@hca2.eclinicaldirectplus.com

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20150319000611 KS Practitioner - Nurse Practitioner 3375860976 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Health Medical Group of Overland Park, LLCGroup PAC ID 0244425841, 8 clinicians

Practice addresses (Care Compare)

13801 Metcalf Ave
Suite 100
Overland Park, KS 66223-3092
Phone (913) 491-1616

5721 W 119TH St
Overland Park, KS 66209-3722
Phone (913) 498-6000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
53-76641-082KSMDFamily Nurse Practitioner
2015001951MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Medical Group of Overland Park, LLC CurrentSince Apr 6, 2019 Accepting new patients
Statland Medical Group LLC CurrentSince Nov 19, 2017 Accepting new patients
Statland Clinic LTD Past Accepting new patients

Locations

12140 Nall Ave
Ste 100
Overland Park, KS 66209
Phone (913) 451-8500

5701 W 119th St
Ste 240
Overland Park, KS 66209
Phone (816) 333-6000

5701 W 119th St
Ste 330
Overland Park, KS 66209
Phone (913) 345-3650

5721 W 119th St
Shawnee Msn, KS 66209
Phone (913) 253-3000

Interoperability endpoints

  • Direct secure messaging: christopher.pelton@hca2.eclinicaldirectplus.com

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1424649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641254400000",
    "number": "1184016529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12140 NALL AVE STE 100",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662092504",
            "telephone_number": "816-943-0706",
            "fax_number": "913-451-1754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 NW MURRAY RD",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640811428",
            "telephone_number": "816-525-4400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12140 Nall Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Overland Park",
            "state": "KS",
            "postal_code": "662092504",
            "country_code": "US",
            "telephone_number": "816-943-0706",
            "fax_number": "913-451-1754",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PELTON",
        "first_name": "CHRISTOPHER",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-02-23",
        "last_updated": "2022-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2015001951",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "53-76641-082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "CHRISTOPHER.PELTON@hca2.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "12140 Nall Ave Ste 100",
            "city": "Overland Park",
            "state": "KS",
            "country_code": "US",
            "postal_code": "662092504",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lee's Summit, MO

Sources for this page

Verify at the official NPI Registry.