Individual provider Active NPI

Susan M. Blum Kratky, APRN

  • Adult Health Clinical Nurse Specialist
  • Kansas City, MO
National Provider Identifier
1215474895
Registry record updated Jan 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Clinical Nurse SpecialistTaxonomy code 364SA2200X
License
104502 Issued in MO
Practice address
3515 Broadway Blvd
Kansas City, MO 64111-2537
Phone
(816) 932-3300
NPI assigned
Jan 20, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 20, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Clinical Nurse Specialist 364SA2200X 104502 MO Primary

Addresses

Primary practice location

3515 Broadway Blvd
Kansas City, MO 64111-2537

Mailing address

5844 Fontana Dr
Fairway, KS 66205-3150
Phone (913) 384-4871

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1484870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484870400000",
    "number": "1215474895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5844 FONTANA DR",
            "city": "FAIRWAY",
            "state": "KS",
            "postal_code": "662053150",
            "telephone_number": "913-384-4871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3515 BROADWAY BLVD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641112537",
            "telephone_number": "816-932-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRATKY",
        "first_name": "SUSAN",
        "middle_name": "M. BLUM",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-20",
        "last_updated": "2017-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "MO",
            "license": "104502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.