NPIMap

Individual provider Active NPI

Kerri Lynn Keberlein-Lynn, ARNP, FNP-C

  • Nurse Practitioner
  • Gladstone, MO
National Provider Identifier
1821024688
Registry record updated Apr 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
154978 Issued in MO
Practice address
6420 N Prospect Ave
Gladstone, MO 64119
Phone
(913) 945-9700
Fax
(913) 945-9707
NPI assigned
Jun 24, 2006
Last updated
Apr 19, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2019

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 44287 KS
Nurse Practitioner 363L00000X 154978 MO Primary

Addresses

Primary practice location

6420 N Prospect Ave
Gladstone, MO 64119

Mailing address

2330 Shawnee Mission Pkwy
Medical Administrative Services of Ku Med, Ste. 312
Westwood, KS 66205-2005
Phone (913) 588-9000

Other identifiers 3

IdentifierTypeStateIssuer
500026194OtherRR MEDICARE
610311OtherFIRSTGUARD KUMW UC
100250480FMedicaidKS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050118000087 MO Practitioner - Nurse Practitioner 4688623697 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Jayhawk Primary Care IncGroup PAC ID 8123928900, 157 clinicians

Practice addresses (Care Compare)

12121 Blue Ridge Ext
Suite M
Grandview, MO 64030-1193
Phone (816) 761-0684

6420 N Prospect Ave
Gladstone, MO 64119-1530

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kansas University Physicians, Inc. CurrentSince Feb 8, 2020 Accepting new patients
Kansas University Physicians Inc CurrentSince Feb 8, 2020 Accepting new patients
Kansas University Physicians Inc Current Accepting new patients
Jayhawk Primary Care Inc CurrentSince Feb 1, 2001 Accepting new patients

Locations

11300 Corporate Ave
Ste 330
Lenexa, KS 66219
Phone (913) 588-6111

7405 Renner Rd
Shawnee Msn, KS 66217
Phone (913) 588-2200

6420 N Prospect Ave
Gladstone, MO 64119
Phone (913) 945-9700

12121 Blue Ridge Ext
Ste M
Grandview, MO 64030
Phone (816) 761-0684

2790 Clay Edwards Dr
Ste 405
North Kansas City, MO 64116
Phone (913) 588-3117

Organizations & group practices 4

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": "1151107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555632000000",
    "number": "1821024688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2330 SHAWNEE MISSION PKWY",
            "address_2": "MEDICAL ADMINISTRATIVE SERVICES OF KU MED, STE. 312",
            "city": "WESTWOOD",
            "state": "KS",
            "postal_code": "662052005",
            "telephone_number": "913-588-9000",
            "fax_number": "913-588-9822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6420 N PROSPECT AVE",
            "city": "GLADSTONE",
            "state": "MO",
            "postal_code": "64119",
            "telephone_number": "913-945-9700",
            "fax_number": "913-945-9707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEBERLEIN-LYNN",
        "first_name": "KERRI",
        "middle_name": "LYNN",
        "credential": "ARNP, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-24",
        "last_updated": "2019-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KS",
            "license": "44287",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "154978",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "500026194",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRSTGUARD KUMW UC",
            "identifier": "610311",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100250480F",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gladstone, MO

Sources for this page

Verify at the official NPI Registry.