Jennifer Ann Grant, APRN
Individual provider Active NPI Family Nurse Practitioner · Independence, MO
NPI 1780957290 · NPPES record last updated Aug 23, 2022
Key facts
- NPI
- 1780957290
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 2012008574 (MO)
- Practice address
- 4741 S Arrowhead Dr Suite 13
Independence, MO 64055 - Phone
- (816) 795-6000
- Fax
- (816) 795-6064
- NPI assigned
- Feb 14, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- University of Missouri, Kansas City, School of Medicine, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Agewell Geriatrics
Practice addresses (Care Compare)
10315 Johnson Dr
Shawnee, KS 66203-3065
Phone (816) 226-1182
793 NW 1621St Rd
Bates City, MO 64011-8395
Phone (816) 226-1182
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MO, KS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20121121000068 | MO | Practitioner - Nurse Practitioner | 1052562071 | Reassigns benefits to 2 organizations |
| I20160829002140 | KS | Practitioner - Nurse Practitioner | 1052562071 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14-117878-121 | KS | MD | Registered Nurse |
| 2001016497 | MO | MD | Family Nurse Practitioner |
| 2012008574 | MO | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| KC Geriatrics LLC | Current |
Accepting new patients | |
| Agewell Geriatrics | Current |
Accepting new patients | |
| Urgent Care of Kansas City LLC | Current |
Accepting new patients | |
| New Liberty Hospital Corporation | Past |
Accepting new patients | |
| Mobile Wound Solutions, LLC | Past | Accepting new patients |
Locations
10315 Johnson Dr
Shawnee, KS 66203
Phone (816) 226-1182
4741 S Arrowhead Dr
Ste B
Independence, MO 64055
Phone (816) 795-6000
Interoperability endpoints
- https://api.platform.athenahealth.com/15764/brand/1/csg/1/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 14-117878-121 | KS | |
| Family Nurse Practitioner | 363LF0000X | 2001016497 | MO | |
| Family Nurse Practitioner | 363LF0000X | 53-75607-121 | KS | |
| Family Nurse Practitioner | 363LF0000X | 2012008574 | MO | Yes |
Addresses
Primary practice location
4741 S Arrowhead Dr Suite 13
Independence, MO 64055
Mailing address
1609 Sunset Dr
Kearney, MO 64060
Phone (816) 341-3132
Other names
- Mrs. Jennifer Ann Bosley
Other providers in Independence, MO
- Shelley Graddy
- Patick Grady
- Ashley Adelle Graffam Fizer
- Amy Leann Gragg
- Sophie Granger
- Gray Chiropractic, L.L.C
- James Christopher Gray
- Jane M Gray
- Peter M Gray
- Shalaunda K Gray
All providers in Independence, MO · Family Nurse Practitioner in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 23, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.