Individual provider Active NPI

Tracy A Coltharp, APRN

  • Gerontology Nurse Practitioner
  • Leawood, KS
National Provider Identifier
1750783866
Registry record updated Jan 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
2017011733 Issued in MO
Practice address
4801 College Blvd
Leawood, KS 66211-1628
Phone
(913) 721-3387
Fax
(816) 875-2598
NPI assigned
Sep 19, 2014
Last updated
Jan 20, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 2017011733 MO Primary
Gerontology Nurse Practitioner 363LG0600X 53-76505-012 KS

Addresses

Primary practice location

4801 College Blvd
Leawood, KS 66211-1628

Mailing address

5101 College Blvd
Leawood, KS 66211-1614
Phone (913) 721-3387

Other practice location 1

9001 State Line Rd Ste 300
Kansas City, MO 64114-3212
Phone (816) 363-2600

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
I20141202001674 KS Practitioner - Nurse Practitioner 1850613860 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

9100 W 74TH St
Ahmg Cardiology at Shawnee Mission
Merriam, KS 66204-4004
Phone (913) 676-2000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
53-76505-012KSMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ascentist Physicians Group, LLC CurrentSince Oct 18, 2024 Accepting new patients
CH Specialty Services KS LLC CurrentSince Jan 3, 2024 Accepting new patients
Shawnee Mission Medical Center Inc CurrentSince Mar 9, 2026 Accepting new patients
United Imaging Consultants, LLC PastSince Feb 20, 2018 Accepting new patients

Locations

2300 Hutton Rd
Ste 106
Kansas City, KS 66109
Phone (913) 728-0386

9100 Park St
Lenexa, KS 66215
Phone (913) 888-1900

9100 Park St
Ste 280
Lenexa, KS 66215

1301 S Main St
Ottawa, KS 66067
Phone (785) 229-3367

4820 College Blvd
Ste A
Overland Park, KS 66211

5101 College Blvd
Overland Park, KS 66211

4801 College Blvd
Shawnee Msn, KS 66211
Phone (913) 491-6451

9100 W 74th St
Shawnee Msn, KS 66204
Phone (913) 632-2230

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: tcoltharp@doctorshospital.securechart.com

Organizations & group practices 5

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 5

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": "1411084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737331200000",
    "number": "1750783866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5101 COLLEGE BLVD",
            "city": "LEAWOOD",
            "state": "KS",
            "postal_code": "662111614",
            "telephone_number": "913-721-3387",
            "fax_number": "816-875-2598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 COLLEGE BLVD",
            "city": "LEAWOOD",
            "state": "KS",
            "postal_code": "662111628",
            "telephone_number": "913-721-3387",
            "fax_number": "816-875-2598"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9001 State Line Rd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "MO",
            "postal_code": "641143212",
            "country_code": "US",
            "telephone_number": "816-363-2600",
            "fax_number": "816-523-0068",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLTHARP",
        "first_name": "TRACY",
        "middle_name": "A",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-19",
        "last_updated": "2025-01-20",
        "certification_date": "2025-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MO",
            "license": "2017011733",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "KS",
            "license": "53-76505-012",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leawood, KS

Sources for this page

Verify at the official NPI Registry.