Individual provider Active NPI

Kyle B Thomas

  • Family Nurse Practitioner
  • Maryville, MO
National Provider Identifier
1780195669
Registry record updated Jan 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2017035516 Issued in MO
Practice address
2016 S Main St
Maryville, MO 64468-2655
Phone
(660) 562-7999
Fax
(660) 562-7996
NPI assigned
Oct 18, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2025

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 2017035516 MO
Family Nurse Practitioner 363LF0000X 2017035516 MO Primary

Addresses

Primary practice location

2016 S Main St
Maryville, MO 64468-2655

Mailing address

2016 S Main St
Maryville, MO 64468-2655
Phone (660) 562-7999

Other practice location 1

2790 Clay Edwards Dr Ste 600
Kansas City, MO 64116-3274
Phone (816) 561-3003

Other practice location 2

19550 E 39th St S Ste 410
Independence, MO 64057-2307
Phone (816) 303-2400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20180725002283 MO Practitioner - Nurse Practitioner 1355698150 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SSM Regional Health ServicesGroup PAC ID 8921917352, shared by 13 NPIs, 165 clinicians

Practice addresses (Care Compare)

2016 S Main St
Maryville, MO 64468-2655
Phone (660) 562-2525

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2017035516MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mosaic Medical Center - Maryville CurrentSince Jan 13, 2025 Accepting new patients
Orthopedic Health of Kansas City P.C. CurrentSince May 23, 2018 Accepting new patients
Mosaic Medical Center - Maryville Family CurrentSince Jan 13, 2025 Accepting new patients
Restore Muscle and Joint, LLC CurrentSince Apr 18, 2024 Accepting new patients
Mosaic Medical Center - Maryville Past Accepting new patients

Locations

19550 E 39th St S
Ste 410
Independence, MO 64057
Phone (816) 303-2400

4119 NW Barry Rd
Kansas City, MO 64154
Phone (816) 452-4488

2016 S Main St
Maryville, MO 64468
Phone (660) 562-2525

1950 Diamond Pkwy
Ste 100
North Kansas City, MO 64116
Phone (816) 561-3003

2790 Clay Edwards Dr
Ste 600
North Kansas City, MO 64116
Phone (816) 561-3003

Organizations & group practices 5

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 3

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": "1508284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736208000000",
    "number": "1780195669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2016 S MAIN ST",
            "city": "MARYVILLE",
            "state": "MO",
            "postal_code": "644682655",
            "telephone_number": "660-562-7999",
            "fax_number": "660-562-7996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2016 S MAIN ST",
            "city": "MARYVILLE",
            "state": "MO",
            "postal_code": "644682655",
            "telephone_number": "660-562-7999",
            "fax_number": "660-562-7996"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2790 Clay Edwards Dr Ste 600",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "MO",
            "postal_code": "641163274",
            "country_code": "US",
            "telephone_number": "816-561-3003",
            "fax_number": "816-889-1584",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "19550 E 39th St S Ste 410",
            "address_purpose": "LOCATION",
            "city": "Independence",
            "state": "MO",
            "postal_code": "640572307",
            "country_code": "US",
            "telephone_number": "816-303-2400",
            "fax_number": "816-303-2484",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "KYLE",
        "middle_name": "B",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-18",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2017035516",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2017035516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maryville, MO

Sources for this page

Verify at the official NPI Registry.