Individual provider Active NPI

Katherine Rose Duke, APRN

  • Family Nurse Practitioner
  • Overland Park, KS
National Provider Identifier
1710055082
Registry record updated Aug 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
53-46132-032 Issued in KS
Practice address
4601 W 109TH St Ste 116
Overland Park, KS 66211-1313
Phone
(913) 469-1115
Fax
(913) 948-9164
NPI assigned
Dec 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2022

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 53-46132-032 KS Primary
Family Nurse Practitioner 363LF0000X 2006001233 MO

Addresses

Primary practice location

4601 W 109TH St Ste 116
Overland Park, KS 66211-1313

Mailing address

4601 W 109TH St Ste 116
Overland Park, KS 66211-1313
Phone (913) 469-1115

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
53-46132-032KSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Adult and Pediatric Dermatology CurrentSince Aug 29, 2021 Accepting new patients
Elite MD, Inc Past Accepting new patients

Locations

4601 W 109th St
Ste 116
Overland Park, KS 66211
Phone (913) 469-1115

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660867200000",
    "number": "1710055082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 W 109TH ST STE 116",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662111313",
            "telephone_number": "913-469-1115",
            "fax_number": "913-948-9164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4601 W 109TH ST STE 116",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662111313",
            "telephone_number": "913-469-1115",
            "fax_number": "913-948-9164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUKE",
        "first_name": "KATHERINE",
        "middle_name": "ROSE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-02",
        "last_updated": "2022-08-19",
        "certification_date": "2022-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "53-46132-032",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2006001233",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Aug 19, 2022; 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.