Individual provider Active NPI

Summer Dawn Keller

  • Physician Assistant
  • North Kansas City, MO
National Provider Identifier
1417411828
Registry record updated Jul 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
2790 Clay Edwards Dr
North Kansas City, MO 64116-3276
Phone
(816) 561-3003
NPI assigned
Jan 30, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

2790 Clay Edwards Dr
North Kansas City, MO 64116-3276

Mailing address

11890 Windham Rd
Country Club, MO 64505-9344
Phone (816) 273-7029

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20190314000260 MO Practitioner - Physician Assistant 3072853894 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dunn Physician Services LLCGroup PAC ID 0345787578, 44 clinicians
Urgent Specialty Associates of Missouri LLCGroup PAC ID 2860874831, 39 clinicians

Practice addresses (Care Compare)

2316 E Meyer Blvd
Kansas City, MO 64132-1136
Phone (816) 276-4000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

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 1

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": "1548806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783555200000",
    "number": "1417411828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11890 WINDHAM RD",
            "city": "COUNTRY CLUB",
            "state": "MO",
            "postal_code": "645059344",
            "telephone_number": "816-273-7029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2790 CLAY EDWARDS DR",
            "city": "NORTH KANSAS CITY",
            "state": "MO",
            "postal_code": "641163276",
            "telephone_number": "816-561-3003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "SUMMER",
        "middle_name": "DAWN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-30",
        "last_updated": "2026-07-09",
        "certification_date": "2026-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Kansas City, MO

Sources for this page

Verify at the official NPI Registry.