Individual provider Active NPI

Maithe Enriquez, APRN

  • Adult Health Nurse Practitioner
  • Kansas City, MO
National Provider Identifier
1689622417
Registry record updated Jan 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
086876 Issued in MO
Practice address
2340 E Meyer Blvd, BLDG 2
Suite 392
Kansas City, MO 64132
Phone
(816) 444-7977
Fax
(630) 528-9578
NPI assigned
May 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 086876 MO
Adult Health Nurse Practitioner 363LA2200X 086876 MO Primary

Addresses

Primary practice location

2340 E Meyer Blvd, BLDG 2
Suite 392
Kansas City, MO 64132

Mailing address

4601 W 109TH St Ste 100
Overland Park, KS 66211-1313
Phone (913) 942-0540

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, KS2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040907001076 MO Practitioner - Nurse Practitioner 2365418712 Reassigns benefits to 1 organization
I20061024000505 KS Practitioner - Nurse Practitioner 2365418712 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Metro Infectious Disease Consultants LLC CurrentSince Sep 1, 2017 Accepting new patients
Metro Infectious Disease Consultants, LLC CurrentSince Sep 1, 2017 Accepting new patients
Metro Infusion Center PLLC Past Accepting new patients
United Imaging Consultants, LLC Past Accepting new patients

Locations

901 McClintock Dr
Ste 202
Burr Ridge, IL 60527
Phone (630) 654-4201

4601 W 109th St
Ste 100
Overland Park, KS 66211
Phone (913) 491-0765

1131 SW Winding Rd
Ste 300
Topeka, KS 66615

200 NE 54th St
Unit 111
Kansas City, MO 64118
Phone (816) 455-7400

2340 E Meyer Blvd
Ste 392
Kansas City, MO 64132
Phone (816) 444-7977

2340 E Meyer Blvd
Ste 348
Kansas City, MO 64132
Phone (816) 394-9044

20 NE Saint Lukes Blvd
Ste 300
Lees Summit, MO 64086
Phone (816) 531-4080

931 NE Columbus St
Lees Summit, MO 64086

2821 N Ballas Rd
Ste 118
Saint Louis, MO 63131

Organizations & group practices 4

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": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579478400000",
    "number": "1689622417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 W 109TH ST STE 100",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662111313",
            "telephone_number": "913-942-0540",
            "fax_number": "630-528-9589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2340 E MEYER BLVD, BLDG 2",
            "address_2": "SUITE 392",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "64132",
            "telephone_number": "816-444-7977",
            "fax_number": "630-528-9578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENRIQUEZ",
        "first_name": "MAITHE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-04",
        "last_updated": "2020-01-20",
        "certification_date": "2020-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "086876",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MO",
            "license": "086876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.