Individual provider Active NPI

Regina K McCord, AGNP

  • Gerontology Nurse Practitioner
  • Kansas City, KS
National Provider Identifier
1659123909
Registry record updated Apr 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
AG04240008 Issued in TX
Practice address
411 Haskell Ave
Kansas City, KS 66101-1447
Phone
(913) 296-1558
NPI assigned
Apr 2, 2024
Last updated
Apr 2, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X AG04240008 TX Primary

Addresses

Primary practice location

411 Haskell Ave
Kansas City, KS 66101-1447

Mailing address

411 Haskell Ave
Kansas City, KS 66101-1447
Phone (913) 296-1558

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
I20260512002030 KS Practitioner - Nurse Practitioner 9234673146 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

10940 Parallel Pkwy
Suite K 177
Kansas City, KS 66109-4434

411 Haskell Ave
Kansas City, KS 66101-1447

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AG04240008TXMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Living Healthy & Wealthy, LLC Gerontology CurrentSince Apr 9, 2024 Accepting new patients

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": "1712016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712016000000",
    "number": "1659123909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 HASKELL AVE",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661011447",
            "telephone_number": "913-296-1558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 HASKELL AVE",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661011447",
            "telephone_number": "913-296-1558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCORD",
        "first_name": "REGINA",
        "middle_name": "K",
        "credential": "AGNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-02",
        "last_updated": "2024-04-02",
        "certification_date": "2024-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "AG04240008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, KS

Sources for this page

Verify at the official NPI Registry.