Individual provider Active NPI

Kayla Janae Slack, APRN

  • Family Nurse Practitioner
  • Kansas City, KS
National Provider Identifier
1669065330
Registry record updated Feb 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5379391082 Issued in KS
Practice address
300 Southwest Blvd
Kansas City, KS 66103-2150
Phone
(913) 722-3100
NPI assigned
Feb 14, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5379391082 KS Primary

Addresses

Primary practice location

300 Southwest Blvd
Kansas City, KS 66103-2150

Mailing address

7442 Jefferson St
Kansas City, MO 64114-1520
Phone (620) 218-2402

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5379391082KSMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1613260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613260800000",
    "number": "1669065330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7442 JEFFERSON ST",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641141520",
            "telephone_number": "620-218-2402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 SOUTHWEST BLVD",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661032150",
            "telephone_number": "913-722-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLACK",
        "first_name": "KAYLA",
        "middle_name": "JANAE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-14",
        "last_updated": "2021-02-14",
        "certification_date": "2021-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "5379391082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.