Individual provider Active NPI

Bridget Stillwell

  • Nurse Practitioner
  • Prairie Village, KS
National Provider Identifier
1699132522
Registry record updated Oct 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
53-77103-031 Issued in KS
Practice address
3700 W 83Rd St
Prairie Village, KS 66208-5120
Phone
(913) 660-2202
Fax
(913) 299-3050
NPI assigned
Jan 22, 2016
Last updated
Oct 11, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 53-77103-031 KS Primary

Addresses

Primary practice location

3700 W 83Rd St
Prairie Village, KS 66208-5120

Mailing address

3700 W 83Rd St
Prairie Village, KS 66208-5120
Phone (913) 341-0201

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
I20170606001738 KS Practitioner - Nurse Practitioner 9931476371 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Blue Valley Dermatology LLCGroup PAC ID 9133499973, 12 clinicians

Practice addresses (Care Compare)

7520 W 160TH St
Suite 100
Overland Park, KS 66085-8137
Phone (913) 871-8221

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
53-77103-031KSMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Valley Dermatology LLC CurrentSince Nov 15, 2022 Accepting new patients

Locations

7840 W 165th St
Ste 260
Overland Park, KS 66223
Phone (913) 632-9400

7520 W 160th St
Ste 100
Stilwell, KS 66085
Phone (913) 871-8221

Interoperability endpoints

  • Direct secure messaging: bridget.stillwell@hca2.eclinicaldirectplus.com

Organizations & group practices 2

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": "1453420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665446400000",
    "number": "1699132522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 W 83RD ST",
            "city": "PRAIRIE VILLAGE",
            "state": "KS",
            "postal_code": "662085120",
            "telephone_number": "913-341-0201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 W 83RD ST",
            "city": "PRAIRIE VILLAGE",
            "state": "KS",
            "postal_code": "662085120",
            "telephone_number": "913-660-2202",
            "fax_number": "913-299-3050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STILLWELL",
        "first_name": "BRIDGET",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-22",
        "last_updated": "2022-10-11",
        "certification_date": "2022-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KS",
            "license": "53-77103-031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prairie Village, KS

Sources for this page

Verify at the official NPI Registry.