Individual provider Active NPI

Genaro Olmedo II

  • Family Nurse Practitioner
  • Shawnee, KS
National Provider Identifier
1750976072
Registry record updated Mar 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
79638 Issued in KS
Practice address
11644 W 75TH St Ste 103
Shawnee, KS 66214-1300
Phone
(913) 248-9965
NPI assigned
Mar 8, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 79638 KS Primary

Addresses

Primary practice location

11644 W 75TH St Ste 103
Shawnee, KS 66214-1300

Mailing address

721 N 31St St Ste 101
Kansas City, KS 66102-3972
Phone (913) 621-0074

Other practice location 1

721 N 31st St Ste 101
Kansas City, KS 66102-3972
Phone (913) 621-0074

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
I20250410000182 KS Practitioner - Nurse Practitioner 9638693781 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy & Truth Healthcare Ministry, Inc Family CurrentSince Jan 13, 2025 Accepting new patients
Mercy & Truth Healthcare Ministry, Inc PastSince Dec 18, 2022 Accepting new patients

Locations

721 N 31st St
Ste 101
Kansas City, KS 66102
Phone (913) 248-9965

721 N 31st St
Kansas City, KS 66102
Phone (913) 281-6457

11644 W 75th St
Ste 103
Shawnee, KS 66214
Phone (913) 248-9965

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": "1615161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773014400000",
    "number": "1750976072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "721 N 31ST ST STE 101",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661023972",
            "telephone_number": "913-621-0074",
            "fax_number": "877-223-0571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11644 W 75TH ST STE 103",
            "city": "SHAWNEE",
            "state": "KS",
            "postal_code": "662141300",
            "telephone_number": "913-248-9965"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "721 N 31st St Ste 101",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "KS",
            "postal_code": "661023972",
            "country_code": "US",
            "telephone_number": "913-621-0074",
            "fax_number": "877-223-0571",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLMEDO",
        "first_name": "GENARO",
        "name_suffix": "II",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-08",
        "last_updated": "2026-03-09",
        "certification_date": "2026-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "79638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shawnee, KS

Sources for this page

Verify at the official NPI Registry.