Individual provider Active NPI

Holley Noble, FNP-C

  • Nurse Practitioner
  • Liberty, MO
National Provider Identifier
1770117863
Registry record updated Feb 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
2019046863 Issued in MO
Practice address
2529 Glenn Hendren Dr Ste 202
Liberty, MO 64068-9602
Phone
(816) 781-4800
NPI assigned
Feb 27, 2020
Last updated
Feb 27, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 53-79310-112 KS
Nurse Practitioner 363L00000X 2019046863 MO Primary

Addresses

Primary practice location

2529 Glenn Hendren Dr Ste 202
Liberty, MO 64068-9602

Mailing address

2529 Glenn Hendren Dr Ste 202
Liberty, MO 64068-9602

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, KS2 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
I20200519002795 MO Practitioner - Nurse Practitioner 4183055569 Reassigns benefits to 1 organization
I20200519002923 KS Practitioner - Nurse Practitioner 4183055569 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kansas City Urology Care PAGroup PAC ID 9032006853, 71 clinicians

Practice addresses (Care Compare)

10701 Nall Ave
Suite 100
Overland Park, KS 66211-1244
Phone (913) 341-7985

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
53-79310-112KSMDNurse Practitioner
2019046863MOMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kansas City Urology Care, P.a. CurrentSince Jun 1, 2020 Accepting new patients

Locations

10701 Nall Ave
Ste 100
Overland Park, KS 66211
Phone (913) 338-5585

8551 Bluejacket St
Overland Park, KS 66214
Phone (913) 341-7985

4321 Washington St
Ste 5300
Kansas City, MO 64111
Phone (816) 531-1234

2529 Glenn Hendren Dr
Ste 202
Liberty, MO 64068
Phone (816) 781-4800

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, 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": "1582761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582761600000",
    "number": "1770117863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2529 GLENN HENDREN DR STE 202",
            "city": "LIBERTY",
            "state": "MO",
            "postal_code": "640689602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2529 GLENN HENDREN DR STE 202",
            "city": "LIBERTY",
            "state": "MO",
            "postal_code": "640689602",
            "telephone_number": "816-781-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOBLE",
        "first_name": "HOLLEY",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-27",
        "last_updated": "2020-02-27",
        "certification_date": "2020-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KS",
            "license": "53-79310-112",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2019046863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Liberty, MO

Sources for this page

Verify at the official NPI Registry.