Individual provider Active NPI

Clara Nicole Ryan, APRN

  • Family Nurse Practitioner
  • Kansas City, KS
National Provider Identifier
1770332801
Registry record updated Oct 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
53-83233-012 Issued in KS
Practice address
3825 Cambridge St
Kansas City, KS 66103-2271
Phone
(913) 588-1227
NPI assigned
May 13, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2024

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 2023032740 MO
Family Nurse Practitioner 363LF0000X 53-83233-012 KS Primary

Addresses

Primary practice location

3825 Cambridge St
Kansas City, KS 66103-2271

Mailing address

12904 S Widmer St
Olathe, KS 66062-8802

Other names 1

  • Clara Nicole Kiedrowski Former name

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
I20240725003814 KS Practitioner - Nurse Practitioner 3375089337 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3901 Rainbow Blvd
Kansas City, KS 66160-8500
Phone (913) 588-7743

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
53-83233-012KSMDFamily Nurse Practitioner
2023032740MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Kansas Hospital Authority CurrentSince Jul 11, 2024 Accepting new patients
University of Kansas Hospital Authority CurrentSince Jul 11, 2024 Accepting new patients

Locations

4000 Cambridge St
Kansas City, KS 66160
Phone (913) 588-0000

3901 Rainbow Blvd
Kansas City, KS 66160
Phone (913) 588-6005

11300 Corporate Ave
Lenexa, KS 66219
Phone (913) 574-0600

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 2

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": "1715558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729209600000",
    "number": "1770332801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12904 S WIDMER ST",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660628802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3825 CAMBRIDGE ST",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661032271",
            "telephone_number": "913-588-1227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "CLARA",
        "middle_name": "NICOLE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-13",
        "last_updated": "2024-10-18",
        "certification_date": "2024-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2023032740",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "53-83233-012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CLARA",
            "last_name": "KIEDROWSKI",
            "middle_name": "NICOLE",
            "credential": "APRN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Kansas City, KS

Sources for this page

Verify at the official NPI Registry.