Individual provider Active NPI

Cynthia Lynne Moore, APRN

  • Family Nurse Practitioner
  • Shawnee, KS
National Provider Identifier
1396748752
Registry record updated Jan 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
44641 Issued in KS
Practice address
7405 Renner Rd
Shawnee, KS 66217-9414
Phone
(913) 588-2200
Fax
(913) 588-8423
NPI assigned
May 31, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 44641 KS Primary

Addresses

Primary practice location

7405 Renner Rd
Shawnee, KS 66217-9414

Mailing address

6955 Greenwood St
Shawnee, KS 66216-3905
Phone (816) 589-3464

Other identifiers 1

IdentifierTypeStateIssuer
100454830AMedicaidKS

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
I20050916000847 KS Practitioner - Nurse Practitioner 6709819196 Reassigns benefits to 2 organizations
I20090504000293 MO Practitioner - Nurse Practitioner 6709819196 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kansas University Physicians IncGroup PAC ID 8921911587, shared by 4 NPIs, 1,809 clinicians

Practice addresses (Care Compare)

1403 Grand Blvd
Kansas City, MO 64106-2917
Phone (913) 574-2273

7405 Renner Rd
Shawnee, KS 66217-9414
Phone (913) 588-6600

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
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
44641KSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kansas University Physicians Inc Current Accepting new patients
Jayhawk Primary Care Inc Current Accepting new patients
Jayhawk Primary Care Inc CurrentSince Aug 13, 2018 Accepting new patients
Kansas University Physicians, Inc. CurrentSince Feb 5, 2020 Accepting new patients
Kansas University Physicians Inc Current Accepting new patients
Kansas University Physicians Inc CurrentSince Feb 5, 2020 Accepting new patients
Providence Care Inc Past Accepting new patients
Shawnee Mission Medical Center Inc Past Accepting new patients
Shawnee Mission Medical Center, Inc. Past Accepting new patients

Locations

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

7405 Renner Rd
Shawnee Msn, KS 66217
Phone (913) 588-2200

12121 Blue Ridge Ext
Ste M
Grandview, MO 64030
Phone (816) 761-0684

1403 Grand Blvd
Kansas City, MO 64106
Phone (816) 268-4295

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

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1117497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705017600000",
    "number": "1396748752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6955 GREENWOOD ST",
            "city": "SHAWNEE",
            "state": "KS",
            "postal_code": "662163905",
            "telephone_number": "816-589-3464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7405 RENNER RD",
            "city": "SHAWNEE",
            "state": "KS",
            "postal_code": "662179414",
            "telephone_number": "913-588-2200",
            "fax_number": "913-588-8423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "CYNTHIA",
        "middle_name": "LYNNE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-05-31",
        "last_updated": "2024-01-12",
        "certification_date": "2024-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "44641",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100454830A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shawnee, KS

Sources for this page

Verify at the official NPI Registry.