Individual provider Active NPI

Nancy J. Washburn, ANP-BC, AOCNP

  • Adult Health Nurse Practitioner
  • Overland Park, KS
National Provider Identifier
1679546147
Registry record updated Dec 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
44830 Issued in KS
Practice address
12200 W 110TH St
Overland Park, KS 66210-4045
Phone
(913) 574-2650
Fax
(913) 574-2769
NPI assigned
Feb 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2018

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 089297 MO
Adult Health Nurse Practitioner 363LA2200X 44830 KS Primary
Registered Nurse 163W00000X 81691 KS
Registered Nurse 163W00000X 089297 MO

Addresses

Primary practice location

12200 W 110TH St
Overland Park, KS 66210-4045

Mailing address

11300 Corporate Ave
Lenexa, KS 66219-1374
Phone (913) 574-2800

Other identifiers 3

IdentifierTypeStateIssuer
100387600CMedicaidKS
100387600BMedicaidKS
1679546147MedicaidMO

Other names 1

  • Nancy J. Davis Former name

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
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
81691KSMDRegistered Nurse
089297MOMDRegistered Nurse
44830KSMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kansas City Cancer Center, LLC Past 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544486400000",
    "number": "1679546147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11300 CORPORATE AVE",
            "city": "LENEXA",
            "state": "KS",
            "postal_code": "662191374",
            "telephone_number": "913-574-2800",
            "fax_number": "913-574-2336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12200 W 110TH ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662104045",
            "telephone_number": "913-574-2650",
            "fax_number": "913-574-2769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASHBURN",
        "first_name": "NANCY",
        "middle_name": "J.",
        "credential": "ANP-BC, AOCNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-07",
        "last_updated": "2018-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MO",
            "license": "089297",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "KS",
            "license": "44830",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KS",
            "license": "81691",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "089297",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100387600C",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100387600B",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1679546147",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NANCY",
            "last_name": "DAVIS",
            "middle_name": "J.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Overland Park, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2018; 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.