NPIMap

Individual provider Active NPI

Annette Christine Villena, APRN-C

  • Nurse Practitioner
  • North Kansas City, MO
National Provider Identifier
1275579682
Registry record updated Mar 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
2020016186 Issued in MO
Practice address
2790 Clay Edwards Dr Ste 520
North Kansas City, MO 64116-3274
Phone
(816) 221-6750
Fax
(816) 221-2335
NPI assigned
Jun 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 53-45357 KS
Primary Care Nurse Practitioner 363LP2300X 45357 KS
Nurse Practitioner 363L00000X 2020016186 MO Primary

Addresses

Primary practice location

2790 Clay Edwards Dr Ste 520
North Kansas City, MO 64116-3274

Mailing address

2790 Clay Edwards Dr Ste 520
North Kansas City, MO 64116-3274
Phone (816) 221-6750

Other identifiers 2

IdentifierTypeStateIssuer
200612400BMedicaidKS
068002211OtherKSMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200708000366 MO Practitioner - Nurse Practitioner 5092869305 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Meritas Health CorporationGroup PAC ID 6305748153, 492 clinicians

Practice addresses (Care Compare)

2790 Clay Edwards Dr
Suite 520
North Kansas City, MO 64116-3274
Phone (816) 221-6750

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
53-45357KSMDNurse Practitioner
2020016186MOMDNurse Practitioner
45357KSMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Meritas Health Corporation CurrentSince Sep 1, 2020 Accepting new patients
Meritas Health Corporation Current Accepting new patients
Meritas Health Corporation CurrentSince Sep 1, 2020 Accepting new patients
Meritas Health Corporation Past Accepting new patients
Meritas Health Corporation Past Accepting new patients

Locations

9411 N Oak Trfy
Ste 260
Kansas City, MO 64155
Phone (816) 453-4000

9411 N Oak Trfy
Ste LL1
Kansas City, MO 64155
Phone (816) 436-7072

2790 Clay Edwards Dr
Ste 520
North Kansas City, MO 64116
Phone (816) 551-6750

Organizations & group practices 5

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.

Hospital & facility affiliations 6

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": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679875200000",
    "number": "1275579682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2790 CLAY EDWARDS DR STE 520",
            "city": "NORTH KANSAS CITY",
            "state": "MO",
            "postal_code": "641163274",
            "telephone_number": "816-221-6750",
            "fax_number": "816-221-2335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2790 CLAY EDWARDS DR STE 520",
            "city": "NORTH KANSAS CITY",
            "state": "MO",
            "postal_code": "641163274",
            "telephone_number": "816-221-6750",
            "fax_number": "816-221-2335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLENA",
        "first_name": "ANNETTE",
        "middle_name": "CHRISTINE",
        "credential": "APRN-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-22",
        "last_updated": "2023-03-27",
        "certification_date": "2023-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KS",
            "license": "53-45357",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "KS",
            "license": "45357",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2020016186",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200612400B",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "068002211",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Kansas City, MO

Sources for this page

Verify at the official NPI Registry.