Individual provider Active NPI

Amy Astel Waller, APRN-BC

  • Nurse Practitioner
  • Lee's Summit, MO
National Provider Identifier
1255358875
Registry record updated Jul 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
136973 Issued in MO
Practice address
3601 NE Ralph Powell Rd Ste a
Lees Summit, MO 64064-2316
Phone
(816) 836-2200
Fax
(816) 836-2244
NPI assigned
Jul 17, 2006
Last updated
Jul 29, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 53-45679-011 KS
Nurse Practitioner 363L00000X 136973 MO Primary

Addresses

Primary practice location

3601 NE Ralph Powell Rd Ste a
Lees Summit, MO 64064-2316

Mailing address

3601 NE Ralph Powell Rd Ste a
Lees Summit, MO 64064-2316
Phone (816) 836-2200

Other practice location 1

1110 Columbine Dr
Holton, KS 66436-8824
Phone (785) 364-2116

Other names 1

  • Mrs. Amy Astel Wray Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS, MO2 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
I20050917000430 KS Practitioner - Nurse Practitioner 4183657281 Reassigns benefits to 3 organizations
I20051026001101 MO Practitioner - Nurse Practitioner 4183657281 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Gi Health LLCGroup PAC ID 1850657347, 3 clinicians
Digestive Health Specialists LLCGroup PAC ID 9739494832, 69 clinicians

Practice addresses (Care Compare)

3601 NE Ralph Powell Rd
Lees Summit, MO 64064-2358
Phone (816) 836-2200

3800 S Whitney Ave
Independence, MO 64055-6739
Phone (816) 478-4887

7820 W 165TH St
Advent Health South Hospital
Overland Park, KS 66223-3021
Phone (816) 554-3838

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
53-45679-011KSMDAdult Health Nurse Practitioner
136973MOMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rural Health Resources of Jackson Co Inc CurrentSince Oct 1, 2025 Accepting new patients
Rural Health Resources of Jackson Co Inc CurrentSince Oct 1, 2025 Accepting new patients
Digestive Health Specialists, LLC CurrentSince Jul 18, 2017 Accepting new patients
Rural Health Resources of Jackson Co Inc CurrentSince Oct 1, 2025 Accepting new patients
Northland Gastroenterology Past Accepting new patients
Midwest Gi Health LLC Past Accepting new patients
Rural Health Resources of Jackson Co Inc Past Accepting new patients
Summit Gastroenterology LLC PastSince Oct 31, 2005 Accepting new patients
Schreier Family Medicine LLC PastSince Apr 11, 2021 Accepting new patients

Locations

1110 Columbine Dr
Holton, KS 66436
Phone (785) 364-2126

7820 W 165th St
Overland Park, KS 66223
Phone (913) 232-9846

3800 S Whitney Ave
Ste 100
Independence, MO 64055

110 NE Saint Lukes Blvd
Ste 530
Lees Summit, MO 64086

Interoperability endpoints

  • Direct secure messaging: amy.waller.1@16424.direct.athenahealth.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/CAJHCA

Organizations & group practices 9

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 7

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785283200000",
    "number": "1255358875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 NE RALPH POWELL RD STE A",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640642316",
            "telephone_number": "816-836-2200",
            "fax_number": "816-836-2244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 NE RALPH POWELL RD STE A",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640642316",
            "telephone_number": "816-836-2200",
            "fax_number": "816-836-2244"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1110 Columbine Dr",
            "address_purpose": "LOCATION",
            "city": "Holton",
            "state": "KS",
            "postal_code": "664368824",
            "country_code": "US",
            "telephone_number": "785-364-2116",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLER",
        "first_name": "AMY",
        "middle_name": "ASTEL",
        "name_prefix": "Mrs.",
        "credential": "APRN-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2026-07-29",
        "certification_date": "2026-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KS",
            "license": "53-45679-011",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "136973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "WRAY",
            "middle_name": "ASTEL",
            "prefix": "MRS.",
            "credential": "APRN-BC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lee's Summit, MO

Sources for this page

Verify at the official NPI Registry.