Individual provider Active NPI

Gracielle Cromwell, FNP-C

  • Family Nurse Practitioner
  • Overland Park, KS
National Provider Identifier
1205232477
Registry record updated Aug 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
53-76595-122 Issued in KS
Practice address
11900 W 135TH St
Overland Park, KS 66221-9400
Phone
(866) 389-2727
NPI assigned
Nov 14, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2020

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 53-76595-122 KS Primary
Family Nurse Practitioner 363LF0000X 2014039717 MO

Addresses

Primary practice location

11900 W 135TH St
Overland Park, KS 66221-9400

Mailing address

11900 W 135TH St
Overland Park, KS 66221-9400
Phone (866) 389-2727

Other names 1

  • Grace Cromwell Other name

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
I20160202002150 KS Practitioner - Nurse Practitioner 4183940893 Reassigns benefits to 1 organization

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
Minuteclinic Diagnostic of Kansas PAGroup PAC ID 7416043807, 139 clinicians

Practice addresses (Care Compare)

11900 W 135TH St
Overland Park, KS 66221-9400
Phone (800) 389-2727

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
53-76595-122KSMDFamily Nurse Practitioner
2014039717MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic Diagnostic of Kansas PA Family CurrentSince Aug 28, 2020 Accepting new patients

Locations

11900 W 135th St
Overland Park, KS 66221
Phone (913) 814-7003

11729 Roe Ave
Shawnee Mission, KS 66211
Phone (877) 646-2546

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1415923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596844800000",
    "number": "1205232477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11900 W 135TH ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662219400",
            "telephone_number": "866-389-2727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11900 W 135TH ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662219400",
            "telephone_number": "866-389-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROMWELL",
        "first_name": "GRACIELLE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-14",
        "last_updated": "2020-08-08",
        "certification_date": "2020-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "53-76595-122",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2014039717",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GRACE",
            "last_name": "CROMWELL",
            "credential": "FNP-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Overland Park, KS

Sources for this page

Verify at the official NPI Registry.