Individual provider Active NPI

Enrique Gonzalez-Garcia

  • Family Nurse Practitioner
  • Kansas City, KS
National Provider Identifier
1629544028
Registry record updated Jan 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5383954042 Issued in KS
Practice address
340 N 26TH St
Kansas City, KS 66102-4630
Phone
(267) 205-6484
NPI assigned
Oct 23, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 136082 KS
Family Nurse Practitioner 363LF0000X 5383954042 KS Primary

Addresses

Primary practice location

340 N 26TH St
Kansas City, KS 66102-4630

Mailing address

340 N 26TH St
Kansas City, KS 66102-4630

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
I20250204003477 KS Practitioner - Nurse Practitioner 1355871450 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
136082KSMDRegistered Nurse
5383954042KSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Preferred Podiatry Group of Kansas LLC CurrentSince Dec 1, 2024 Accepting new patients

Locations

101 Lee Ave
Columbus, KS 66725
Phone (620) 429-2134

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1540252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736985600000",
    "number": "1629544028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 N 26TH ST",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661024630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 N 26TH ST",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661024630",
            "telephone_number": "267-205-6484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ-GARCIA",
        "first_name": "ENRIQUE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-23",
        "last_updated": "2025-01-16",
        "certification_date": "2024-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KS",
            "license": "136082",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "5383954042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, KS

Sources for this page

Verify at the official NPI Registry.