Individual provider Active NPI

Nicole Mattison, APRN

  • Family Nurse Practitioner
  • Kansas City, KS
National Provider Identifier
1366859365
Registry record updated Feb 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
53-79004 Issued in KS
Practice address
4000 Cambridge St Ste 600
Kansas City, KS 66160-8262
Phone
(913) 588-9600
NPI assigned
Jul 22, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2019038975 MO
Clinical Nurse Specialist 364S00000X 53-74753-052 KS
Family Nurse Practitioner 363LF0000X 53-79004 KS Primary

Addresses

Primary practice location

4000 Cambridge St Ste 600
Kansas City, KS 66160-8262

Mailing address

4000 Cambridge St Ste G600
Kansas City, KS 66160-8501

Other practice location 1

10787 Nall Ave Ste 300
Overland Park, KS 66211-1372
Phone (913) 588-9400

Other practice location 2

5701 State Ave Ste 300
Kansas City, KS 66102-1286
Phone (913) 945-9640

Other practice location 3

1000 E 101st Ter
Kansas City, MO 64131-3366
Phone (913) 574-2430

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
I20200329000035 KS Practitioner - Nurse Practitioner 3971932807 Reassigns benefits to 2 organizations
I20200424000217 MO Practitioner - Nurse Practitioner 3971932807 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mid-America Cardiology Associates IncGroup PAC ID 7012801103, 110 clinicians
Kansas University Physicians IncGroup PAC ID 8921911587, 1,809 clinicians

Practice addresses (Care Compare)

10787 Nall Ave
Suite 300
Overland Park, KS 66211-1372
Phone (913) 588-9400

11300 Corporate Ave
Suite 342
Lenexa, KS 66219-1368

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

4000 Cambridge St
Kansas City, KS 66160-8500

7420 Switzer Rd
Shawnee, KS 66203-4550
Phone (913) 588-1227

Hospital & facility affiliations

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
53-74753-052KSMDClinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Kansas University Physicians Inc Current Accepting new patients
Kansas University Physicians Inc CurrentSince Apr 1, 2025 Accepting new patients
Mid-America Cardiology Associates, Inc. CurrentSince Mar 10, 2020 Accepting new patients
Kansas University Physicians Inc Current Accepting new patients
Kansas University Physicians Inc Past Accepting new patients

Locations

820 Ravenhill Dr
Ste 160A
Atchison, KS 66002
Phone (913) 367-6227

4000 Cambridge St
Ste 600
Kansas City, KS 66160
Phone (913) 588-9600

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

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

4000 Cambridge St
Ste G600
Kansas City, KS 66160
Phone (913) 588-7743

5701 State Ave
Ste 300
Kansas City, KS 66102
Phone (913) 279-5450

10787 Nall Ave
Ste 300
Overland Park, KS 66211
Phone (913) 588-9400

7420 Switzer Rd
Shawnee Mission, KS 66203
Phone (913) 262-9201

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

1530 N Church Rd
Liberty, MO 64068
Phone (816) 415-1900

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

3943 Sherman Ave
Saint Joseph, MO 64506
Phone (816) 279-6666

Organizations & group practices 5

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 4

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": "1405987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582070400000",
    "number": "1366859365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 CAMBRIDGE ST STE G600",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661608501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 CAMBRIDGE ST STE 600",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661608262",
            "telephone_number": "913-588-9600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10787 Nall Ave Ste 300",
            "address_purpose": "LOCATION",
            "city": "Overland Park",
            "state": "KS",
            "postal_code": "662111372",
            "country_code": "US",
            "telephone_number": "913-588-9400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5701 State Ave Ste 300",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "KS",
            "postal_code": "661021286",
            "country_code": "US",
            "telephone_number": "913-945-9640",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 E 101st Ter",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "MO",
            "postal_code": "641313366",
            "country_code": "US",
            "telephone_number": "913-574-2430",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATTISON",
        "first_name": "NICOLE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-22",
        "last_updated": "2020-02-19",
        "certification_date": "2020-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2019038975",
            "primary": false
        },
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "KS",
            "license": "53-74753-052",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "53-79004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, KS

Sources for this page

Verify at the official NPI Registry.