Individual provider Active NPI

Crystal Sheets

  • Family Nurse Practitioner
  • Kansas City, MO
National Provider Identifier
1225537665
Registry record updated Dec 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2018004924 Issued in MO
Practice address
7900 Lees Summit Rd
Kansas City, MO 64139-1236
Phone
(816) 404-7500
Fax
(816) 404-7514
NPI assigned
Feb 12, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2018004924 MO Primary

Addresses

Primary practice location

7900 Lees Summit Rd
Kansas City, MO 64139-1236

Mailing address

1221 SE 12TH St
Lees Summit, MO 64081-2905

Other practice location 1

1221 SE 12th St
Lees Summit, MO 64081-2905
Phone (816) 305-8641

Other identifiers 1

IdentifierTypeStateIssuer
420052915MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, KS2 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

Enrollment IDStateProvider typePAC IDDetails
I20180501002549 MO Practitioner - Nurse Practitioner 9830453786 Reassigns benefits to 3 organizations
I20180626001161 KS Practitioner - Nurse Practitioner 9830453786 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Truman Medical Center IncorporatedGroup PAC ID 7315841418, 237 clinicians

Practice addresses (Care Compare)

7900 Lees Summit Rd
Kansas City, MO 64139-1236
Phone (816) 404-7000

Merit-based Incentive Payment System (MIPS)

Final score
92.67 of 100Reported as group
Quality
93.94
Improvement activities
40
Cost
86.7

Merit-based Incentive Payment System (MIPS)

Final score
91.52 of 100Reported as group
Quality
90.41
Improvement activities
40
Cost
79.08

Merit-based Incentive Payment System (MIPS)

Final score
90.39 of 100Reported as group
Quality
67.9
Promoting interoperability
100
Improvement activities
40
Cost
78.87

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mep Kansas LLC CurrentSince May 1, 2019 Accepting new patients
Truman Medical Center Incorporated CurrentSince Nov 26, 2018 Accepting new patients
Truman Medical Center, Incorporated CurrentSince Nov 26, 2018 Accepting new patients
Truman Medical Center, Incorporated Current Accepting new patients
VA Eastern Kansas Health Care System CurrentSince Feb 10, 2019 Accepting new patients
University Health Physicians CurrentSince Jan 1, 2021 Accepting new patients
Truman Medical Center Incorporated Current Accepting new patients

Locations

10544 Parallel Pkwy
Kansas City, KS 66109
Phone (844) 285-1005

13405 S Blackbob Rd
Olathe, KS 66062
Phone (913) 222-8325

4720 Johnson Dr
Roeland Park, KS 66205
Phone (913) 222-8399

14950 W 67th St
Shawnee, KS 66216
Phone (913) 222-8404

13200 State Line Rd
Shawnee Mission, KS 66209
Phone (913) 222-8380

12300 Metcalf Ave
Shawnee Mission, KS 66213
Phone (913) 317-7000

4401 Wornall Rd
Kansas City, MO 64111
Phone (816) 932-2107

4407 E 50th Ter
Kansas City, MO 64130
Phone (816) 924-1201

7900 Lees Summit Rd
Kansas City, MO 64139
Phone (816) 373-4485

100 NE Saint Lukes Blvd
Lees Summit, MO 64086
Phone (816) 347-5097

601 S US Highway 169
Smithville, MO 64089
Phone (816) 532-3999

Organizations & group practices 7

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": "1518393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606953600000",
    "number": "1225537665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 SE 12TH ST",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640812905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7900 LEES SUMMIT RD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641391236",
            "telephone_number": "816-404-7500",
            "fax_number": "816-404-7514"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1221 SE 12th St",
            "address_purpose": "LOCATION",
            "city": "Lees Summit",
            "state": "MO",
            "postal_code": "640812905",
            "country_code": "US",
            "telephone_number": "816-305-8641",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHEETS",
        "first_name": "CRYSTAL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-12",
        "last_updated": "2020-12-03",
        "certification_date": "2020-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2018004924",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "420052915",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.