Individual provider Active NPI

Jana C Kistler, ARNP -C

  • Adult Health Nurse Practitioner
  • Kansas City, KS
National Provider Identifier
1376652404
Registry record updated Mar 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
45753 Issued in KS
Practice address
3901 Rainbow Blvd
Suite G600
Kansas City, KS 66160-8500
Phone
(913) 588-9600
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 14-65120-081 KS
Registered Nurse 163W00000X 095648 MO
Adult Health Nurse Practitioner 363LA2200X 45753 KS Primary

Addresses

Primary practice location

3901 Rainbow Blvd
Suite G600
Kansas City, KS 66160-8500

Mailing address

5501 NW 62ND Ter
Suite 201
Kansas City, MO 64151-2411
Phone (816) 584-8884

Other identifiers 2

IdentifierTypeStateIssuer
1376652404MedicaidMO
200358780AMedicaidKS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
14-65120-081KSMDRegistered Nurse
095648MOMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425945600000",
    "number": "1376652404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5501 NW 62ND TER",
            "address_2": "SUITE 201",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641512411",
            "telephone_number": "816-584-8884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 RAINBOW BLVD",
            "address_2": "SUITE G600",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661608500",
            "telephone_number": "913-588-9600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISTLER",
        "first_name": "JANA",
        "middle_name": "C",
        "credential": "ARNP -C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2015-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KS",
            "license": "14-65120-081",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "095648",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "KS",
            "license": "45753",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1376652404",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200358780A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.