Individual provider Active NPI

Charis Grosdidier, APRN

  • Gerontology Nurse Practitioner
  • Lawrence, KS
National Provider Identifier
1508236365
Registry record updated Oct 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
76945 Issued in KS
Practice address
1130 W 4TH St Ste 2050
Lawrence, KS 66044-1333
Phone
(785) 505-3636
Fax
(785) 505-5210
NPI assigned
Oct 5, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 76945 KS Primary

Addresses

Primary practice location

1130 W 4TH St Ste 2050
Lawrence, KS 66044-1333

Mailing address

325 Maine Street
Mso Library
Lawrence, KS 66044-1360
Phone (785) 505-2988

Other practice location 1

3901 Rainbow Blvd
Kansas City, KS 66160-8500
Phone (913) 588-5000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address charis.grosdidier1@direct.lmh.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20160607001021 KS Practitioner - Nurse Practitioner 9739479502 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lawrence Physicians LLCGroup PAC ID 1951623834, 223 clinicians

Practice addresses (Care Compare)

1130 W 4TH St
2050 Cardiovascular Specialists of Lawrence
Lawrence, KS 66044-1333
Phone (785) 841-3636

Hospital & facility affiliations

  • LMH Hospital, Lawrence, KS, CCN 170137

Merit-based Incentive Payment System (MIPS)

Final score
87.1 of 100Reported as group
Quality
79.76
Promoting interoperability
99
Improvement activities
40
Cost
78.08

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
76945KSMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lawrence Physicians LLC CurrentSince Dec 15, 2021 Accepting new patients
Mid-America Cardiology Associates, Inc. CurrentSince Nov 10, 2018 Accepting new patients
Lawrence Physicians LLC Current Accepting new patients
Lawrence Physicians LLC CurrentSince Dec 15, 2021 Accepting new patients
The Internal Medicine Group PA Past Accepting new patients

Locations

4000 Cambridge St
Ste G600
Kansas City, KS 66160
Phone (913) 588-7743

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

1130 W 4th St
Ste 2050
Lawrence, KS 66044
Phone (785) 505-3636

325 Maine St
Lawrence, KS 66044
Phone (785) 505-2988

10787 Nall Ave
Ste 300
Overland Park, KS 66211
Phone (913) 588-9400

Interoperability endpoints

  • Direct secure messaging: charis.grosdidier1@direct.lmh.org

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": "1444003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1508236365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 MAINE STREET",
            "address_2": "MSO LIBRARY",
            "city": "LAWRENCE",
            "state": "KS",
            "postal_code": "660441360",
            "telephone_number": "785-505-2988",
            "fax_number": "785-505-5228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 W 4TH ST STE 2050",
            "city": "LAWRENCE",
            "state": "KS",
            "postal_code": "660441333",
            "telephone_number": "785-505-3636",
            "fax_number": "785-505-5210"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3901 Rainbow Blvd",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "KS",
            "postal_code": "661608500",
            "country_code": "US",
            "telephone_number": "913-588-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GROSDIDIER",
        "first_name": "CHARIS",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-05",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "KS",
            "license": "76945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "charis.grosdidier1@direct.lmh.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1130 W 4th St Ste 2050",
            "city": "Lawrence",
            "state": "KS",
            "country_code": "US",
            "postal_code": "660441333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lawrence, KS

Sources for this page

Verify at the official NPI Registry.