Individual provider Active NPI

Dawn L Graves, MSN, RN

  • Nurse Practitioner
  • Excelsior Springs, MO
National Provider Identifier
1619162518
Registry record updated Mar 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
111885 Issued in MO
Practice address
197 N McCleary Rd
Excelsior Springs, MO 64024-8490
Phone
(816) 922-2970
Fax
(816) 637-2480
NPI assigned
Sep 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 111885 MO Primary
Nurse Practitioner 363L00000X 1497663091 KS

Addresses

Primary practice location

197 N McCleary Rd
Excelsior Springs, MO 64024-8490

Mailing address

10134 Reynolds Rd
Orrick, MO 64077-8049
Phone (816) 288-5164

Other identifiers 1

IdentifierTypeStateIssuer
P00631991OtherMORAILROAD MEDICARE PIN

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
I20210510000471 MO Order and Referring Only - Nurse Practitioner 0143317636

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
1497663091KSMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ozarks Medical Center Past Accepting new patients
Geriatric Health Services, Inc. Past Accepting new patients
Geriatric Healthcare Services, LLC Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1189641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426723200000",
    "number": "1619162518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10134 REYNOLDS RD",
            "city": "ORRICK",
            "state": "MO",
            "postal_code": "640778049",
            "telephone_number": "816-288-5164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "197 N MCCLEARY RD",
            "city": "EXCELSIOR SPRINGS",
            "state": "MO",
            "postal_code": "640248490",
            "telephone_number": "816-922-2970",
            "fax_number": "816-637-2480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAVES",
        "first_name": "DAWN",
        "middle_name": "L",
        "credential": "MSN, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-13",
        "last_updated": "2015-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "111885",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KS",
            "license": "1497663091",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PIN",
            "identifier": "P00631991",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Excelsior Springs, MO

Sources for this page

Verify at the official NPI Registry.