Individual provider Active NPI

Mary Elizabeth Medford, ACNPC-AG

  • Acute Care Nurse Practitioner
  • Shawnee, KS
National Provider Identifier
1346914090
Registry record updated Aug 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
2021030039 Issued in MO
Practice address
21905 W 51St Ter
Shawnee, KS 66226-3874
Phone
(701) 361-9431
NPI assigned
Aug 5, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 53-80387-122 KS
Acute Care Nurse Practitioner 363LA2100X 2021030039 MO Primary

Addresses

Primary practice location

21905 W 51St Ter
Shawnee, KS 66226-3874

Mailing address

21905 W 51St Ter
Shawnee, KS 66226-3874
Phone (701) 361-9431

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20211227001132 KS Practitioner - Nurse Practitioner 2264823301 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kansas University Physicians IncGroup PAC ID 8921911587, 1,809 clinicians

Practice addresses (Care Compare)

4000 Cambridge St
Kansas City, KS 66160-0001
Phone (913) 588-1227

Hospital & facility affiliations

  • University of Kansas Hospital Hospital, Kansas City, KS, CCN 170040
  • University of Kansas Health System Olathe Hospital Hospital, Olathe, KS, CCN 170049

Merit-based Incentive Payment System (MIPS)

Final score
92.91 of 100Reported as apm
Quality
77.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
53-80387-122KSMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kansas University Physicians Inc Current Accepting new patients

Locations

3901 Rainbow Blvd
Kansas City, KS 66160
Phone (913) 588-6005

4000 Cambridge St
Kansas City, KS 66160
Phone (913) 588-0000

11300 Corporate Ave
Ste 330
Lenexa, KS 66219
Phone (913) 588-6111

1000 E 101st Ter
Kansas City, MO 64131
Phone (816) 333-1326

2790 Clay Edwards Dr
Ste 405
North Kansas City, MO 64116
Phone (913) 588-3117

Organizations & group practices 1

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1628121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628121600000",
    "number": "1346914090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21905 W 51ST TER",
            "city": "SHAWNEE",
            "state": "KS",
            "postal_code": "662263874",
            "telephone_number": "701-361-9431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21905 W 51ST TER",
            "city": "SHAWNEE",
            "state": "KS",
            "postal_code": "662263874",
            "telephone_number": "701-361-9431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDFORD",
        "first_name": "MARY",
        "middle_name": "ELIZABETH",
        "credential": "ACNPC-AG",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-05",
        "last_updated": "2021-08-05",
        "certification_date": "2021-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "KS",
            "license": "53-80387-122",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MO",
            "license": "2021030039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shawnee, KS

Sources for this page

Verify at the official NPI Registry.