Individual provider Active NPI

Amanda Skaggs, RNC WHNP

  • Women's Health Nurse Practitioner
  • Liberty, MO
National Provider Identifier
1275517229
Registry record updated Mar 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
143222 Issued in MO
Practice address
2529 Glenn Hendren Dr Ste 200
Liberty, MO 64068-9606
Phone
(816) 781-7820
Fax
(816) 781-2371
NPI assigned
Dec 2, 2005
Last updated
Mar 18, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 143222 MO Primary

Addresses

Primary practice location

2529 Glenn Hendren Dr Ste 200
Liberty, MO 64068-9606

Mailing address

2529 Glenn Hendren Dr Ste 200
Liberty, MO 64068-9606
Phone (816) 781-7820

Other identifiers 1

IdentifierTypeStateIssuer
425394301MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20110414000795 MO Practitioner - Nurse Practitioner 2567646573 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Kansas City Medical College, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northland Obstetrics and Gynecology, Inc.Group PAC ID 7012986730, 10 clinicians

Practice addresses (Care Compare)

2529 Glenn Hendren Dr
Suite 200
Liberty, MO 64068-9606
Phone (816) 781-7820

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
143222MOMDWomen's Health Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1133481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300406400000",
    "number": "1275517229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2529 GLENN HENDREN DR STE 200",
            "city": "LIBERTY",
            "state": "MO",
            "postal_code": "640689606",
            "telephone_number": "816-781-7820",
            "fax_number": "816-781-2371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2529 GLENN HENDREN DR STE 200",
            "city": "LIBERTY",
            "state": "MO",
            "postal_code": "640689606",
            "telephone_number": "816-781-7820",
            "fax_number": "816-781-2371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKAGGS",
        "first_name": "AMANDA",
        "name_prefix": "Ms.",
        "credential": "RNC WHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-02",
        "last_updated": "2011-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "MO",
            "license": "143222",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "425394301",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Liberty, MO

Sources for this page

Verify at the official NPI Registry.