Active NPI
Summer Dawn Keller
- Physician Assistant
- North Kansas City, MO
National Provider Identifier
1417411828
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
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
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.
-
- Hospitalist Physician
- Kansas City, MO
- NPI 1437990082
-
- Surgical Critical Care Physician
- Kansas City, MO
- NPI 1992436422
-
- Hospitalist Physician
- Independence, MO
- NPI 1841997905
-
- Orthopaedic Surgery Physician
- North Kansas City, MO
- NPI 1336188242
-
- Physical Medicine & Rehabilitation Physician
- Chicago, IL
- NPI 1285942722
MO
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Kansas City, MO
- NPI 1134187842
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.