Individual provider Active NPI

Scott Blackmer, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Kansas City, MO
National Provider Identifier
1659118974
Registry record updated Oct 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
2024038213 Issued in MO
Practice address
2600 E 12TH St
Kansas City, MO 64127-1321
Phone
(816) 965-1100
NPI assigned
Jul 12, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 2024038213 MO Primary

Addresses

Primary practice location

2600 E 12TH St
Kansas City, MO 64127-1321

Mailing address

1555 NE Rice Rd
Lees Summit, MO 64086-5849

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
I20241029002806 MO Practitioner - Nurse Practitioner 9133652191 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
RediscoverGroup PAC ID 3375453517, 50 clinicians

Practice addresses (Care Compare)

2600 E 12TH St
Kansas City, MO 64127-1321
Phone (816) 965-1100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2024038213MOMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rediscover CurrentSince Sep 19, 2024 Accepting new patients
Rediscover CurrentSince Sep 19, 2024 Accepting new patients

Locations

3211 Woodland Ave
Kansas City, MO 64109
Phone (816) 931-6500

2600 E 12th St
Kansas City, MO 64127
Phone (816) 404-6170

1555 NE Rice Rd
Lees Summit, MO 64086
Phone (816) 347-3069

901 NE Independence Ave
Lees Summit, MO 64086
Phone (816) 246-1800

Organizations & group practices 2

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 3

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": "1720742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728604800000",
    "number": "1659118974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1555 NE RICE RD",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640865849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 E 12TH ST",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641271321",
            "telephone_number": "816-965-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKMER",
        "first_name": "SCOTT",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-07-12",
        "last_updated": "2024-10-11",
        "certification_date": "2024-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MO",
            "license": "2024038213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.