Kelly Andra, M.D.
Individual provider Active NPI Internal Medicine Physician · Overland Park, KS
NPI 1275754202 · NPPES record last updated Feb 3, 2017
Key facts
- NPI
- 1275754202
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 0438218 (KS)
- Practice address
- 10787 Nall Ave
Suite 310
Overland Park, KS 66211-1375 - Phone
- (913) 945-6900
- Fax
- (913) 945-6970
- NPI assigned
- May 1, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 10
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- University of Kansas School of Med (KC/Wich/Sal), 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Jayhawk Primary Care Inc
Practice addresses (Care Compare)
10787 Nall Ave
310 Medical Plaza Internal Medicine
Overland Park, KS 66211-1301
Phone (913) 945-6900
Hospital & facility affiliations
- Interim Healthcare of Kansas City
- Lakeview Village Home Health
- University of Kansas Hospital
- Kansas City Orthopaedic Institute
- Saint Luke'S East Hospital
- University of Kansas Health System Olathe Hospital
- St Lukes Hospital of Kansas City
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150724010589 | KS | Practitioner - Internal Medicine | 8820180995 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0438218 | KS | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jayhawk Primary Care Inc | Internal Medicine | Current |
Accepting new patients |
| Jayhawk Primary Care Inc | Internal Medicine | Current | Accepting new patients |
| Jayhawk Primary Care Inc | Internal Medicine | Current |
Accepting new patients |
| Jayhawk Primary Care Inc | Past | Accepting new patients |
Locations
10787 Nall Ave
Ste 310
Overland Park, KS 66211
Phone (913) 945-6900
7405 Renner Rd
Shawnee Msn, KS 66217
Phone (913) 588-2200
Interoperability endpoints
- kandra534274@direct.kuha.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 2007015074 | MO | |
| Internal Medicine Physician | 207R00000X | 0438218 | KS | Yes |
Addresses
Primary practice location
10787 Nall Ave
Suite 310
Overland Park, KS 66211-1375
Mailing address
10787 Nall Ave
Suite 310
Overland Park, KS 66211-1375
Phone (913) 945-6900
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 205481609 | Medicaid | MO |
Other providers in Overland Park, KS
- Sandra L. Anderson
- Susan Joan Anderson
- Terry D Anderson
- Tia Anderson
- Wendy Anderson
- Lincoln Andreasen
- Charles Perry Andrews IV
- Chloe Andrews
- Kameche Andrews
- Robert Duane Anesi
All providers in Overland Park, KS · Internal Medicine Physician in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 3, 2017. 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.