Individual provider Active NPI

Hannah Ederle

  • Family Nurse Practitioner
  • Shawnee, KS
National Provider Identifier
1306529110
Registry record updated Aug 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
TMP-161840 Issued in KS
Practice address
5004 Payne St
Shawnee, KS 66226-2337
Phone
(913) 481-1708
NPI assigned
Aug 8, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X TMP-161840 KS Primary

Addresses

Primary practice location

5004 Payne St
Shawnee, KS 66226-2337

Mailing address

5004 Payne St
Shawnee, KS 66226-2337
Phone (913) 481-1708

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
I20231121002750 KS Practitioner - Nurse Practitioner 8325496896 Reassigns benefits to 1 organization
I20231209000559 MO Practitioner - Nurse Practitioner 8325496896 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TMP-161840KSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health Medical Associates of Kansas LLC CurrentSince Oct 18, 2023 Accepting new patients
Signify Health, LLC CurrentSince Nov 5, 2023 Accepting new patients

Locations

2300 Main St
Fl 9
Kansas City, MO 64108
Phone (800) 416-1767

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1691452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692921600000",
    "number": "1306529110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5004 PAYNE ST",
            "city": "SHAWNEE",
            "state": "KS",
            "postal_code": "662262337",
            "telephone_number": "913-481-1708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5004 PAYNE ST",
            "city": "SHAWNEE",
            "state": "KS",
            "postal_code": "662262337",
            "telephone_number": "913-481-1708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDERLE",
        "first_name": "HANNAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-08",
        "last_updated": "2023-08-25",
        "certification_date": "2023-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "TMP-161840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shawnee, KS

Sources for this page

Verify at the official NPI Registry.