Nicole B Valdivia, NP
Individual provider Active NPI Adult Health Nurse Practitioner · N Kansas City, MO
NPI 1346595907 · NPPES record last updated Jul 19, 2012
Key facts
- NPI
- 1346595907
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Adult Health Nurse Practitioner 363LA2200X
- License
- 2012008571 (MO)
- Practice address
- 2700 Clay Edwards Dr
Suite 300
N Kansas City, MO 64116-3251 - Phone
- (816) 842-0171
- Fax
- (816) 842-3582
- NPI assigned
- Jul 19, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Advanced Urologic Associates Inc
Practice addresses (Care Compare)
12300 Metcalf Ave
Overland Park, KS 66213-1324
Phone (816) 251-5100
12330 Metcalf Ave
Suite 500a
Overland Park, KS 66213-1313
Phone (816) 251-5100
19001 E 48TH St S
Independence, MO 64055-6964
Phone (816) 251-5100
Hospital & facility affiliations
- Saint Luke'S East Hospital
- Saint Luke'S South Hospital
- St Lukes Hospital of Kansas City
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MO, KS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20121004000186 | MO | Practitioner - Nurse Practitioner | 7719136951 | Reassigns benefits to 2 organizations |
| I20180626002358 | KS | Practitioner - Nurse Practitioner | 7719136951 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2012008571 | MO | MD | Adult Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advanced Urologic Associates, Inc | Current |
Accepting new patients | |
| Ozarks Medical Center | Past | Accepting new patients | |
| Urology Specialists PC | Past | Accepting new patients |
Locations
12330 Metcalf Ave
Ste 500A
Overland Park, KS 66213
Phone (913) 323-9000
615 W Nursery St
Butler, MO 64730
Phone (660) 200-2004
19001 E 48th St S
Independence, MO 64055
Phone (816) 836-6875
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 2012008571 | MO | Yes |
Addresses
Primary practice location
2700 Clay Edwards Dr
Suite 300
N Kansas City, MO 64116-3251
Mailing address
2700 Clay Edwards Dr
Suite 300
N Kansas City, MO 64116-3251
Phone (816) 842-0171
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2012008571 | Other | MO | ANP LICENSE NUMBER |
Other providers in N Kansas City, MO
- Salas Chiropractic LLC
- Charles Craig Satterlee
- Steven B Smith
- Alexandra J Strong
- US Medgroup of Kansas PA
- Jennifer Louise Vaughan
- Amy Wastler
- Wellness Life Systems LLC
- Matthew B. Woody
All providers in N Kansas City, MO · Adult Health Nurse Practitioner in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 19, 2012. 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.