Individual provider Active NPI

Tanairi Kennedy

  • Women's Health Nurse Practitioner
  • Gladstone, MO
National Provider Identifier
1285408674
Registry record updated Nov 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
5382574012 Issued in KS
Practice address
2900 NE 60TH St Ste 100
Gladstone, MO 64119-2091
Phone
(816) 453-6000
NPI assigned
Nov 7, 2023
Last updated
Nov 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2023

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 5382574012 KS Primary

Addresses

Primary practice location

2900 NE 60TH St Ste 100
Gladstone, MO 64119-2091

Mailing address

1905 159TH Ter
Basehor, KS 66007-8701
Phone (913) 972-5097

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, KS2 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
I20231127002425 MO Practitioner - Nurse Practitioner 7517315880 Reassigns benefits to 1 organization
I20250304000591 KS Practitioner - Nurse Practitioner 7517315880 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Missouri, Kansas City, School of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Physician Services LLCGroup PAC ID 1658500962, 39 clinicians

Practice addresses (Care Compare)

7440 W Frontage Rd
Merriam, KS 66203-4670
Phone (913) 236-6455

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5382574012KSMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Samuel U. Rodgers Health Center, Inc CurrentSince Dec 18, 2023 Accepting new patients
Samuel U. Rodgers Health Center, Inc. CurrentSince Dec 18, 2023 Accepting new patients
Mid America Physician Services LLC CurrentSince Dec 31, 2024 Accepting new patients
Comprehensive Health of Planned Parenthood Great Plains PastSince Nov 12, 2023 Accepting new patients
Johnson County OB-GYN Chartered PastSince Dec 31, 2024 Accepting new patients
Womens Care Past Accepting new patients
Planned Parenthood Great Plains Women's Health PastSince Nov 12, 2023 Accepting new patients

Locations

8801 Monrovia St
Lenexa, KS 66215

8801 Monrovia St
Ste 200
Lenexa, KS 66215

7440 W Frontage Rd
Shawnee Msn, KS 66203
Phone (913) 236-6455

9301 W 74th St
Ste 325
Shawnee Msn, KS 66204
Phone (913) 384-4990

825 Euclid Ave
Kansas City, MO 64124
Phone (816) 889-4816

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 7

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1699315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699315200000",
    "number": "1285408674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1905 159TH TER",
            "city": "BASEHOR",
            "state": "KS",
            "postal_code": "660078701",
            "telephone_number": "913-972-5097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 NE 60TH ST STE 100",
            "city": "GLADSTONE",
            "state": "MO",
            "postal_code": "641192091",
            "telephone_number": "816-453-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "TANAIRI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-07",
        "last_updated": "2023-11-07",
        "certification_date": "2023-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "KS",
            "license": "5382574012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gladstone, MO

Sources for this page

Verify at the official NPI Registry.