Individual provider Active NPI

Tori Theiss

  • Family Nurse Practitioner
  • Lee's Summit, MO
National Provider Identifier
1417537275
Registry record updated Nov 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2021040986 Issued in MO
Practice address
20 NE Saint Lukes Blvd Ste 200
Lees Summit, MO 64086-6001
Phone
(816) 347-5100
NPI assigned
Apr 14, 2021
Last updated
Nov 12, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 12, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2021040986 MO Primary
Registered Nurse 163W00000X 2018007906 MO

Addresses

Primary practice location

20 NE Saint Lukes Blvd Ste 200
Lees Summit, MO 64086-6001

Mailing address

20 NE Saint Lukes Blvd Ste 200
Lees Summit, MO 64086-6001
Phone (816) 347-5100

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
I20211202002957 MO Practitioner - Nurse Practitioner 5496145542 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Saint Lukes Physician Group IncGroup PAC ID 3577476894, 1,233 clinicians

Practice addresses (Care Compare)

20 NE Saint Lukes Blvd
350 Saint Lukes Medical Group
Lee's Summit, MO 64086-6001
Phone (816) 347-5600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2018007906MOMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Luke's Physician Group Inc Single Specialty CurrentSince Jan 16, 2022 Accepting new patients

Locations

901 E 104th St
Ste 400
Kansas City, MO 64131
Phone (816) 502-8752

20 NE Saint Lukes Blvd
Ste 200
Lees Summit, MO 64086
Phone (816) 347-5100

20 NE Saint Lukes Blvd
Ste 350
Lees Summit, MO 64086
Phone (816) 347-5600

601 S US Highway 169
Smithville, MO 64089
Phone (816) 532-3999

Interoperability endpoints

  • Direct secure messaging: ttheiss229797@direct.saint-lukes.org

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1618358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636675200000",
    "number": "1417537275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 NE SAINT LUKES BLVD STE 200",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640866001",
            "telephone_number": "816-347-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 NE SAINT LUKES BLVD STE 200",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640866001",
            "telephone_number": "816-347-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEISS",
        "first_name": "TORI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-14",
        "last_updated": "2021-11-12",
        "certification_date": "2021-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2021040986",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "2018007906",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lee's Summit, MO

Sources for this page

Verify at the official NPI Registry.