Individual provider Active NPI

Katherine Wilson

  • Adult Health Nurse Practitioner
  • Lee's Summit, MO
National Provider Identifier
1710496351
Registry record updated Apr 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
2022028990 Issued in MO
Practice address
2861 NE Independence Ave Ste 201
Lees Summit, MO 64064-2379
Phone
(816) 525-2840
Fax
(816) 525-2841
NPI assigned
Sep 27, 2017
Last updated
Apr 8, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 53-77899 KS
Adult Health Nurse Practitioner 363LA2200X 2022028990 MO Primary

Addresses

Primary practice location

2861 NE Independence Ave Ste 201
Lees Summit, MO 64064-2379

Mailing address

2861 NE Independence Ave Ste 201
Lees Summit, MO 64064-2379
Phone (816) 525-2840

Other practice location 1

11340 Nall Ave Ste 200
Overland Park, KS 66211-1234
Phone (816) 525-2840

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS, MO2 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
I20171207002123 KS Practitioner - Nurse Practitioner 0941567457 Reassigns benefits to 1 organization
I20260422000299 MO Practitioner - Nurse Practitioner 0941567457 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Missouri, Kansas City, School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Orthopedics and Sports MedicineGroup PAC ID 8820370422, 45 clinicians

Practice addresses (Care Compare)

11340 Nall Ave
Suite 200
Overland Park, KS 66211-1234
Phone (816) 525-2840

2861 NE Independence Ave
Suite 201
Lees Summit, MO 64064-2379
Phone (816) 525-2840

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.28 of 100Reported as group
Quality
78.53
Promoting interoperability
99
Improvement activities
40
Cost
63.24

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
53-77899KSMDAdult Health Nurse Practitioner
2022028990MOMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Menorah Medical Group, LLC CurrentSince Nov 12, 2017 Accepting new patients
Menorah Medical Group, LLC Past Accepting new patients

Locations

5701 W 119th St
Ste 410
Overland Park, KS 66209
Phone (913) 345-3650

5721 W 119th St
Shawnee Msn, KS 66209
Phone (913) 253-3000

Interoperability endpoints

  • Direct secure messaging: katherine.wilson@hca2.eclinicaldirectplus.com

Organizations & group practices 3

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1506470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775606400000",
    "number": "1710496351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2861 NE INDEPENDENCE AVE STE 201",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640642379",
            "telephone_number": "816-525-2840",
            "fax_number": "816-525-2841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2861 NE INDEPENDENCE AVE STE 201",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640642379",
            "telephone_number": "816-525-2840",
            "fax_number": "816-525-2841"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11340 Nall Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Overland Park",
            "state": "KS",
            "postal_code": "662111234",
            "country_code": "US",
            "telephone_number": "816-525-2840",
            "fax_number": "816-525-2841",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "KATHERINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-27",
        "last_updated": "2026-04-08",
        "certification_date": "2026-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "KS",
            "license": "53-77899",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MO",
            "license": "2022028990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lee's Summit, MO

Sources for this page

Verify at the official NPI Registry.