Individual provider Active NPI

Rebecca Jill Flynn

  • Pediatric Nurse Practitioner
  • Kansas City, MO
National Provider Identifier
1780029637
Registry record updated May 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
2013004392 Issued in MO
Practice address
2401 Gillham Rd
Kansas City, MO 64108-4619
Phone
(816) 234-3000
NPI assigned
May 6, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 2013004392 MO Primary

Addresses

Primary practice location

2401 Gillham Rd
Kansas City, MO 64108-4619

Mailing address

4301 SE Secretariat Dr
Lees Summit, MO 64082-4927
Phone (859) 396-9229

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2013004392MOMDPediatric Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1367798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367798400000",
    "number": "1780029637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 SE SECRETARIAT DR",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640824927",
            "telephone_number": "859-396-9229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 GILLHAM RD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641084619",
            "telephone_number": "816-234-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLYNN",
        "first_name": "REBECCA",
        "middle_name": "JILL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-06",
        "last_updated": "2013-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MO",
            "license": "2013004392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.