Individual provider Active NPI

Ina Whitacre, PA-C

  • Physician Assistant
  • Kansas City, MO
National Provider Identifier
1689926115
Registry record updated Oct 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2012035063 Issued in MO
Practice address
920 Main St
Suite 300
Kansas City, MO 64105-2017
Phone
(816) 559-6359
Fax
(816) 559-6368
NPI assigned
Oct 8, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2012035063 MO Primary

Addresses

Primary practice location

920 Main St
Suite 300
Kansas City, MO 64105-2017

Mailing address

920 Main St
Suite 300
Kansas City, MO 64105-2017
Phone (816) 559-6369

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
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2012035063MOMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
EMS, 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": "1349654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349654400000",
    "number": "1689926115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 MAIN ST",
            "address_2": "SUITE 300",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641052017",
            "telephone_number": "816-559-6369",
            "fax_number": "816-559-6368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 MAIN ST",
            "address_2": "SUITE 300",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641052017",
            "telephone_number": "816-559-6359",
            "fax_number": "816-559-6368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITACRE",
        "first_name": "INA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-08",
        "last_updated": "2012-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2012035063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2012; 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.