Individual provider Active NPI

Cheryl Coons

  • Psychiatric/Mental Health Nurse Practitioner
  • Lenexa, KS
National Provider Identifier
1770108680
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
79384 Issued in KS
Practice address
8629 Bluejacket St
Lenexa, KS 66214-1604
Phone
(913) 677-3553
Fax
(913) 677-8328
NPI assigned
Jun 16, 2020
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

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.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Missouri, Kansas City, School of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Clinical Associates PA 23 clinicians

Practice addresses (Care Compare)

8629 Bluejacket St
Lenexa, KS 66214-1604
Phone (913) 677-3553

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.

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20240130002889 KS Practitioner - Nurse Practitioner 6901259555 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2008029934MOMDRegistered Nurse
79384KSMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Clinical Associates PA CurrentSince Oct 13, 2023 Accepting new patients

Locations

8629 Bluejacket St
Overland Park, KS 66214
Phone (913) 677-3553

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 2008029934 MO
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 79384 KS Primary

Addresses

NPPES NPI Registry

Primary practice location

8629 Bluejacket St
Lenexa, KS 66214-1604

Mailing address

4310 NE 61St CT
Kansas City, MO 64119-5311
Phone (816) 674-4922

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 29, 2024.

{
    "created_epoch": "1592265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1770108680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4310 NE 61ST CT",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641195311",
            "telephone_number": "816-674-4922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8629 BLUEJACKET ST",
            "city": "LENEXA",
            "state": "KS",
            "postal_code": "662141604",
            "telephone_number": "913-677-3553",
            "fax_number": "913-677-8328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COONS",
        "first_name": "CHERYL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-16",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "2008029934",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KS",
            "license": "79384",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lenexa, KS

Sources for this page

Verify at the official NPI Registry.