Individual provider Active NPI

Melanie Jean Fullmer, APRN

  • Acute Care Nurse Practitioner
  • North Kansas City, MO
National Provider Identifier
1467113852
Registry record updated Aug 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
53-84398-071 Issued in KS
Practice address
2790 Clay Edwards Dr Ste 520
North Kansas City, MO 64116-3274
Phone
(816) 691-5198
Fax
(816) 346-7095
NPI assigned
Jan 6, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X 2021051080 MO
Acute Care Nurse Practitioner 363LA2100X 2022004714 MO
Acute Care Nurse Practitioner 363LA2100X 53-84398-071 KS Primary

Addresses

Primary practice location

2790 Clay Edwards Dr Ste 520
North Kansas City, MO 64116-3274

Mailing address

2790 Clay Edwards Dr Ste 520
North Kansas City, MO 64116-3274
Phone (816) 691-5198

Other practice location 1

4000 Cambridge St
Kansas City, KS 66160-3274
Phone (913) 588-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, KS2 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
I20220215000090 MO Practitioner - Nurse Practitioner 6709279714 Reassigns benefits to 1 organization
I20250827004876 KS Practitioner - Nurse Practitioner 6709279714 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
Group practices
Meritas Health CorporationGroup PAC ID 6305748153, 492 clinicians
Kansas University Physicians IncGroup PAC ID 8921911587, 1,809 clinicians

Practice addresses (Care Compare)

2790 Clay Edwards Dr
Suite 520
North Kansas City, MO 64116-3274
Phone (816) 221-6750

4000 Cambridge St
Kansas City, KS 66160-0001
Phone (913) 588-1227

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2021051080MOMDCritical Care Medicine Registered Nurse
53-84398-071KSMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Meritas Health Corporation CurrentSince Feb 28, 2022 Accepting new patients
Kansas University Physicians Inc Current Accepting new patients
Kansas University Physicians Inc CurrentSince Aug 25, 2025 Accepting new patients
Meritas Health Corporation CurrentSince Feb 28, 2022 Accepting new patients
Kansas University Physicians Inc CurrentSince Aug 25, 2025 Accepting new patients
Meritas Health Corporation Current Accepting new patients
Meritas Health Corporation Past Accepting new patients
Meritas Health Corporation Past Accepting new patients

Locations

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

4000 Cambridge St
Kansas City, KS 66160
Phone (913) 588-0000

11300 Corporate Ave
Ste 342
Lenexa, KS 66219
Phone (913) 574-0425

9411 N Oak Trfy
Ste 260
Kansas City, MO 64155
Phone (816) 453-4000

9411 N Oak Trfy
Ste LL1
Kansas City, MO 64155
Phone (816) 436-7072

2700 Clay Edwards Dr
Ste 400
North Kansas City, MO 64116
Phone (816) 421-4240

2790 Clay Edwards Dr
Ste 520
North Kansas City, MO 64116
Phone (816) 551-6750

2790 Clay Edwards Dr
Ste 520B
North Kansas City, MO 64116
Phone (816) 691-5198

Organizations & group practices 8

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 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": "1641427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754438400000",
    "number": "1467113852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2790 CLAY EDWARDS DR STE 520",
            "city": "NORTH KANSAS CITY",
            "state": "MO",
            "postal_code": "641163274",
            "telephone_number": "816-691-5198",
            "fax_number": "816-346-7095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2790 CLAY EDWARDS DR STE 520",
            "city": "NORTH KANSAS CITY",
            "state": "MO",
            "postal_code": "641163274",
            "telephone_number": "816-691-5198",
            "fax_number": "816-346-7095"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4000 Cambridge St",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "KS",
            "postal_code": "661603274",
            "country_code": "US",
            "telephone_number": "913-588-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FULLMER",
        "first_name": "MELANIE",
        "middle_name": "JEAN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-06",
        "last_updated": "2025-08-06",
        "certification_date": "2025-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "MO",
            "license": "2021051080",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MO",
            "license": "2022004714",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "KS",
            "license": "53-84398-071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Kansas City, MO

Sources for this page

Verify at the official NPI Registry.