Individual provider Active NPI

Brianna Frederick, APRN (AGNP-C)

  • Adult Health Nurse Practitioner
  • Lee's Summit, MO
National Provider Identifier
1619837689
Registry record updated Mar 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
2025049901 Issued in MO
Practice address
3521 NE Ralph Powell Rd
Lees Summit, MO 64064-2337
Phone
(816) 533-4398
NPI assigned
Nov 13, 2025
Last updated
Mar 3, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 2025049901 MO Primary
Registered Nurse 163W00000X 13144754042 KS

Addresses

Primary practice location

3521 NE Ralph Powell Rd
Lees Summit, MO 64064-2337

Mailing address

14304 Stearns St
Overland Park, KS 66221-7544

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
I20260402000858 MO Practitioner - Nurse Practitioner 8729563218 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Skin Care IncorporatedGroup PAC ID 2264459650, 5 clinicians

Practice addresses (Care Compare)

3521 NE Ralph Powell Rd
Suite C
Lees Summit, MO 64064-2324
Phone (816) 554-8346

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13144754042KSMDRegistered Nurse
2025049901MOMDAdult Health Nurse Practitioner

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.

NPI Registry JSON

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

{
    "created_epoch": "1762992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772496000000",
    "number": "1619837689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14304 STEARNS ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662217544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3521 NE RALPH POWELL RD",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640642337",
            "telephone_number": "816-533-4398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDERICK",
        "first_name": "BRIANNA",
        "credential": "APRN (AGNP-C)",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-11-13",
        "last_updated": "2026-03-03",
        "certification_date": "2026-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MO",
            "license": "2025049901",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KS",
            "license": "13144754042",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lee's Summit, MO

Sources for this page

Verify at the official NPI Registry.