Individual provider Active NPI

Christopher Roatch, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Overland Park, KS
National Provider Identifier
1730775222
Registry record updated Dec 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
53-79762-011 Issued in KS
Practice address
14209 King St
Overland Park, KS 66221-8009
Phone
(913) 636-4106
NPI assigned
Dec 18, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 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 2020039692 MO
Family Nurse Practitioner 363LF0000X 53-79762-011 KS Primary

Addresses

Primary practice location

14209 King St
Overland Park, KS 66221-8009

Mailing address

14209 King St
Overland Park, KS 66221-8009
Phone (913) 636-4106

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
I20230725003903 KS Practitioner - Nurse Practitioner 6406217363 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osawatomie State HospitalGroup PAC ID 5698053866, 11 clinicians

Practice addresses (Care Compare)

500 State Hospital Dr
Osawatomie, KS 66064-1813
Phone (913) 755-7073

Hospital & facility affiliations

  • Miami County Medical Center Hospital, Paola, KS, CCN 170109

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
53-79762-011KSMDFamily Nurse Practitioner
2020039692MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Osawatomie State Hospital CurrentSince Jun 24, 2023 Accepting new patients
State of Kansas Past Accepting new patients

Locations

500 State Hospital Dr
Osawatomie, KS 66064
Phone (913) 755-7000

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.

Hospital & facility affiliations 1

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": "1608249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608249600000",
    "number": "1730775222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14209 KING ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662218009",
            "telephone_number": "913-636-4106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14209 KING ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662218009",
            "telephone_number": "913-636-4106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROATCH",
        "first_name": "CHRISTOPHER",
        "name_prefix": "Mrs.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-18",
        "last_updated": "2020-12-18",
        "certification_date": "2020-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2020039692",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "53-79762-011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

Verify at the official NPI Registry.