Esi Amedodji, NP
Individual provider Active NPI Family Nurse Practitioner · Kansas City, MO
NPI 1245084417 · NPPES record last updated Apr 21, 2024
Key facts
- NPI
- 1245084417
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 2024012072 (MO)
- Practice address
- 8929 Cambridge Ave Apt 2708
Kansas City, MO 64138-5429 - Phone
- (816) 786-5989
- NPI assigned
- Apr 15, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Theoria Medical
Practice addresses (Care Compare)
4301 NE Parvin Rd
Northland Rehabilitation
Kansas City, MO 64117-3001
Phone (816) 702-8000
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241101000550 | MO | Practitioner - Nurse Practitioner | 9537692249 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2024012072 | MO | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Theoria Medical | Current |
Accepting new patients | |
| Complexcare Medical Group Midwest H PLLC | Current |
Accepting new patients | |
| Signify Health, LLC | Current |
Accepting new patients | |
| Theoria Medical | Past | Accepting new patients |
Locations
41800 W 11 Mile Rd
Ste 109
Novi, MI 48375
Phone (833) 578-2763
3002 John Duffy Dr
Joplin, MO 64804
Phone (417) 553-9767
2300 Main St
Fl 9
Kansas City, MO 64108
Phone (800) 416-1767
9191 N Ambassador Dr
Kansas City, MO 64154
Phone (816) 491-6190
4301 NE Parvin Rd
North Kansas City, MO 64117
Phone (816) 444-0900
2150 W Randolph St
Saint Charles, MO 63301
Phone (636) 946-4966
505 W Evergreen St
Strafford, MO 65757
Phone (417) 736-9332
809 W Benton St
Windsor, MO 65360
Phone (660) 467-3102
4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 2024012072 | MO | Yes |
Addresses
Primary practice location
8929 Cambridge Ave Apt 2708
Kansas City, MO 64138-5429
Mailing address
8929 Cambridge Ave Apt 2708
Kansas City, MO 64138-5429
Phone (816) 786-5989
Other providers in Kansas City, MO
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- Douglas R Ambrose
- Katherine E Ambrosier Groves
- AMC Pharmacy LLC
- America Elderly Care LLC
- America'S Best Contacts & Eyeglasses
- America'S Best Contacts & Eyeglasses
- America'S Best Contacts & Eyeglasses
- America'S Best Contacts and Eyeglasses, Inc.
All providers in Kansas City, MO · Family Nurse Practitioner in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 21, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.