Individual provider Active NPI

Jessica R Kientzy, MSN, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Independence, MO
National Provider Identifier
1346034931
Registry record updated Jul 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
2025021371 Issued in MO
Practice address
17844 E 23Rd St S
Independence, MO 64057-1840
Phone
(816) 254-3652
Fax
(816) 254-9243
NPI assigned
Apr 8, 2025
Last updated
Jul 17, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 2025021371 MO Primary
Registered Nurse 163W00000X 2014024533 MO

Addresses

Primary practice location

17844 E 23Rd St S
Independence, MO 64057-1840

Mailing address

PO Box 844715
Kansas City, MO 64184-4715
Phone (417) 761-5214

Other practice location 1

17421 Medical Center Pkwy
Independence, MO 64057-1805
Phone (816) 455-9975

Other practice location 2

800 S Park Ave
Springfield, MO 65802-4855
Phone (417) 862-3362

Other practice location 3

1805 E Walnut St
Columbia, MO 65201-6425
Phone (573) 777-7500

Other names 1

  • Jessica Ray Former name

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
I20250909001698 MO Practitioner - Nurse Practitioner 3476055278 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Burrell IncGroup PAC ID 4486548625, 217 clinicians

Practice addresses (Care Compare)

17844 E 23Rd St
Burrell Behavioral Health
Independence, MO 64057-1840
Phone (816) 254-3652

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
2014024533MOMDRegistered Nurse
2025021371MOMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Burrell, Inc. CurrentSince Jun 30, 2025 Accepting new patients
Burrell, Inc. CurrentSince Jun 30, 2025 Accepting new patients

Locations

1805 E Walnut St
Columbia, MO 65201
Phone (573) 777-7500

17421 Medical Center Pkwy
Independence, MO 64057
Phone (816) 455-9975

17611 E US Highway 24
#H
Independence, MO 64056
Phone (816) 836-6350

17844 E 23rd St S
Independence, MO 64057
Phone (816) 257-9716

1300 E Bradford Pkwy
#H
Springfield, MO 65804

800 S Park Ave
Springfield, MO 65802
Phone (417) 893-7700

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, 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": "1744070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752710400000",
    "number": "1346034931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844715",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641844715",
            "telephone_number": "417-761-5214",
            "fax_number": "417-761-5065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17844 E 23RD ST S",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640571840",
            "telephone_number": "816-254-3652",
            "fax_number": "816-254-9243"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17421 Medical Center Pkwy",
            "address_purpose": "LOCATION",
            "city": "Independence",
            "state": "MO",
            "postal_code": "640571805",
            "country_code": "US",
            "telephone_number": "816-455-9975",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "800 S Park Ave",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MO",
            "postal_code": "658024855",
            "country_code": "US",
            "telephone_number": "417-862-3362",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1805 E Walnut St",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "MO",
            "postal_code": "652016425",
            "country_code": "US",
            "telephone_number": "573-777-7500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIENTZY",
        "first_name": "JESSICA",
        "middle_name": "R",
        "credential": "MSN, PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-08",
        "last_updated": "2025-07-17",
        "certification_date": "2025-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MO",
            "license": "2025021371",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "2014024533",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "RAY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Independence, MO

Sources for this page

Verify at the official NPI Registry.