Individual provider Active NPI

Lizy Mary Kochipillai, APRN

  • Family Nurse Practitioner
  • Leawood, KS
National Provider Identifier
1679087423
Registry record updated Dec 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
53-77856 Issued in KS
Practice address
10977 Granada LN Ste 105
Leawood, KS 66211-1415
Phone
(913) 215-5008
Fax
(816) 447-3960
NPI assigned
Nov 30, 2017
Last updated
Dec 19, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 19, 2017

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 53-77856 KS Primary

Addresses

Primary practice location

10977 Granada LN Ste 105
Leawood, KS 66211-1415

Mailing address

PO Box 875743
Kansas City, MO 64187-5743
Phone (816) 332-7280

Other practice location 1

15630 Pinehurst Dr Ste 5
Basehor, KS 66007-8238
Phone (913) 662-7042

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
I20171228001190 KS Practitioner - Nurse Practitioner 3678831476 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
May accept Medicare assignment
Group practices
CS Pacs 3 Midwest LLCGroup PAC ID 4183164734, 36 clinicians
Kansas Post Acute Medical Services 1 PAGroup PAC ID 1557634193, 58 clinicians

Practice addresses (Care Compare)

17500 W 119TH St
Olathe, KS 66061-9524
Phone (913) 213-1686

6509 W 103Rd St
Overland Park, KS 66212-1728
Phone (913) 649-3701

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
53-77856KSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kansas Post Acute Medical Services 1 PA Multi-Specialty CurrentSince Aug 1, 2022 Accepting new patients
Inpatient Consultants of Kansas PA Multi-Specialty CurrentSince Aug 1, 2022 Accepting new patients
Curana Health of Missouri-Kansas LLC Multi-Specialty CurrentSince Dec 16, 2017 Accepting new patients
NV Pacs 2 LLC Multi-Specialty CurrentSince Aug 1, 2022 Accepting new patients
Inpatient Consultants of Kansas PA Multi-Specialty CurrentSince Aug 1, 2022 Accepting new patients
CS Pacs 3 Midwest LLC Multi-Specialty CurrentSince Aug 15, 2024 Accepting new patients

Locations

12724 State Line Rd
Leawood, KS 66209
Phone (913) 345-8808

17500 W 119th St
Olathe, KS 66061
Phone (913) 213-1686

6509 W 103rd St
Overland Park, KS 66212
Phone (913) 649-3701

601 E Main St
Pretty Prairie, KS 67570
Phone (620) 459-6822

10500 Quivira Rd
Shawnee Mission, KS 66215
Phone (913) 227-0565

9100 W 74th St
Shawnee Msn, KS 66204
Phone (913) 632-2230

Organizations & group practices 6

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": "1512000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513641600000",
    "number": "1679087423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 875743",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641875743",
            "telephone_number": "816-332-7280",
            "fax_number": "816-447-3932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10977 GRANADA LN STE 105",
            "city": "LEAWOOD",
            "state": "KS",
            "postal_code": "662111415",
            "telephone_number": "913-215-5008",
            "fax_number": "816-447-3960"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15630 Pinehurst Dr Ste 5",
            "address_purpose": "LOCATION",
            "city": "Basehor",
            "state": "KS",
            "postal_code": "660078238",
            "country_code": "US",
            "telephone_number": "913-662-7042",
            "fax_number": "913-662-7046",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOCHIPILLAI",
        "first_name": "LIZY",
        "middle_name": "MARY",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-30",
        "last_updated": "2017-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "53-77856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leawood, KS

Sources for this page

Verify at the official NPI Registry.