Active NPI
Jessica Cullen, PA-C
- Surgical Physician Assistant
- Lee's Summit, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- Practice address
- 2861 NE Independence Ave Ste 201
Lees Summit, MO 64064-2379 - Phone
- (816) 525-2840
- Fax
- (816) 525-2841
- NPI assigned
- Sep 6, 2011
- Last updated
- Jan 7, 2021
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | MO | ||
| Surgical Physician Assistant | 363AS0400X | MO | Primary |
Addresses
Primary practice location
2861 NE Independence Ave Ste 201
Lees Summit, MO 64064-2379
Mailing address
2861 NE Independence Ave Ste 201
Lees Summit, MO 64064-2379
Phone (816) 525-2840
Other practice location 1
12330 Metcalf Ave Ste 400
Overland Park, KS 66213-1307
Phone (816) 525-2840
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO, KS
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
121 N Dean Ave
Suite 101
Raymore, MO 64083-8398
Phone (816) 525-2840
2861 NE Independence Ave
Suite 201
Lees Summit, MO 64064-2379
Phone (816) 525-2840
505 S Hospital Dr
Paola, KS 66071-1850
Phone (816) 525-2840
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advanced Orthopedics and Sports Medicine | Current | Accepting new patients |
Locations
11340 Nall Ave
Ste 200
Overland Park, KS 66211
Phone (913) 354-5020
12330 Metcalf Ave
Ste 400
Overland Park, KS 66213
Phone (913) 317-7990
505 S Hospital Dr
Paola, KS 66071
Phone (913) 232-9846
2861 NE Independence Ave
Ste 201
Lees Summit, MO 64064
Phone (660) 281-8118
121 N Dean Ave
Ste 101
Raymore, MO 64083
Organizations & group practices 2
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.
-
dba Sano Orthopedics
- Orthopaedic Surgery Physician
- Lee's Summit, MO
- NPI 1003268087
KS
-
- Orthopaedic Surgery Physician
- North Kansas City, MO
- NPI 1336188242
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Lee's Summit Medical Center
- General Acute Care Hospital
- Lee's Summit, MO
- NPI 1225085871
-
- General Acute Care Hospital
- Overland Park, KS
- NPI 1154303337
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1315267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1609977600000",
"number": "1467733345",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2861 NE INDEPENDENCE AVE STE 201",
"city": "LEES SUMMIT",
"state": "MO",
"postal_code": "640642379",
"telephone_number": "816-525-2840",
"fax_number": "816-525-2841"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2861 NE INDEPENDENCE AVE STE 201",
"city": "LEES SUMMIT",
"state": "MO",
"postal_code": "640642379",
"telephone_number": "816-525-2840",
"fax_number": "816-525-2841"
}
],
"practiceLocations": [
{
"address_1": "12330 Metcalf Ave Ste 400",
"address_purpose": "LOCATION",
"city": "Overland Park",
"state": "KS",
"postal_code": "662131307",
"country_code": "US",
"telephone_number": "816-525-2840",
"fax_number": "816-525-2841",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CULLEN",
"first_name": "JESSICA",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-09-06",
"last_updated": "2021-01-07",
"certification_date": "2021-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "MO",
"license": null,
"primary": false
},
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "MO",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lee's Summit, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2021; 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.