Georgiana Sue Gonzalez, FNP-BC
Individual provider Active NPI Nurse Practitioner · Kansas City, MO
NPI 1659028678 · NPPES record last updated Sep 7, 2022
Key facts
- NPI
- 1659028678
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 2021043564 (MO)
- Practice address
- 4400 Broadway Blvd Ste 400
Kansas City, MO 64111-3342 - Phone
- (816) 932-0288
- Fax
- (816) 932-7490
- NPI assigned
- Mar 9, 2022
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Advanced Orthopedics and Sports Medicine
Practice addresses (Care Compare)
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
- NKC Health
- Research Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MO, KS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220809001777 | MO | Practitioner - Nurse Practitioner | 1951783893 | Reassigns benefits to 1 organization |
| I20220809001921 | KS | Practitioner - Nurse Practitioner | 1951783893 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science - Nursing
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2021043564 | MO | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advanced Orthopedics and Sports Medicine | Current |
Accepting 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
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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 2021043564 | MO | Yes |
Addresses
Primary practice location
4400 Broadway Blvd Ste 400
Kansas City, MO 64111-3342
Mailing address
901 E 104TH St
Kansas City, MO 64131-4517
Phone (816) 932-0288
Other names
- Georgiana Sue Gonzalez
Other providers in Kansas City, MO
- Alejandro Gonzalez
- Ana Cecilia Gonzalez
- Celia Gonzalez
- Eduardo Enrique Gonzalez
- Evelyn E Gonzalez
- Kylie Gonzalez
- Jordan Elizabeth Gooch
- Good Living Caregivers Agency, LLC
- Good Morning Health Corp
- Good Morning Homes Corp
All providers in Kansas City, MO · Nurse Practitioner in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 7, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.