Individual provider Active NPI

Pamela L. Sisk, APRN, BC

  • Child & Adolescent Psychiatric/Mental Health Registered Nurse
  • Blue Springs, MO
National Provider Identifier
1821061250
Registry record updated Sep 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0807X
License
131115 Issued in MO
Practice address
1200 NW South Outer Rd
Ste 301
Blue Springs, MO 64015-3059
Phone
(816) 795-1881
NPI assigned
Feb 8, 2006
Last updated
Sep 1, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 131115 MO
Child & Adolescent Psychiatric/Mental Health Registered Nurse 163WP0807X 131115 MO Primary
Psychiatric/Mental Health Registered Nurse 163WP0808X 131115 MO

Addresses

Primary practice location

1200 NW South Outer Rd
Ste 301
Blue Springs, MO 64015-3059

Mailing address

1200 NW South Outer Rd
Blue Springs, MO 64015-3065
Phone (816) 286-0222

Other practice location 1

1800 Community
Clinton, MO 64735-8804
Phone (888) 403-1071

Other identifiers 1

IdentifierTypeStateIssuer
423952514MedicaidMO

Other names 1

  • Pamela L Ashford Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, KS2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20131122001473 MO Practitioner - Certified Clinical Nurse Specialist (CNS) 0840230348 Reassigns benefits to 1 organization
Practice locations: Blue Springs, MO
I20141028002628 KS Practitioner - Certified Clinical Nurse Specialist (CNS) 0840230348 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
131115MOMDChild & Adolescent Psychiatric/Mental Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Compass Health, Inc CurrentSince Sep 23, 2019 Accepting new patients
Compass Health, Inc CurrentSince Sep 23, 2019 Accepting new patients
Bert Nash Community Mental Health Center Inc CurrentSince Sep 2, 2014 Accepting new patients
Transformative Effects LLC Past Accepting new patients
Nabil El Halawany, MD Past Accepting new patients

Locations

200 Maine St
Ste A
Lawrence, KS 66044
Phone (785) 832-8192

1800 Community
Clinton, MO 64735
Phone (660) 885-8131

1800 Community
#B
Clinton, MO 64735

301 N 2nd St
Ste C
Odessa, MO 64076
Phone (816) 633-5921

1010 Remington Plz
Raymore, MO 64083
Phone (816) 318-4430

307 N Main St
Windsor, MO 65360
Phone (660) 647-2182

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630454400000",
    "number": "1821061250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 NW SOUTH OUTER RD",
            "city": "BLUE SPRINGS",
            "state": "MO",
            "postal_code": "640153065",
            "telephone_number": "816-286-0222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 NW SOUTH OUTER RD",
            "address_2": "STE 301",
            "city": "BLUE SPRINGS",
            "state": "MO",
            "postal_code": "640153059",
            "telephone_number": "816-795-1881"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1800 Community",
            "address_purpose": "LOCATION",
            "city": "Clinton",
            "state": "MO",
            "postal_code": "647358804",
            "country_code": "US",
            "telephone_number": "888-403-1071",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SISK",
        "first_name": "PAMELA",
        "middle_name": "L.",
        "credential": "APRN, BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-08",
        "last_updated": "2021-09-01",
        "certification_date": "2021-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MO",
            "license": "131115",
            "primary": false
        },
        {
            "code": "163WP0807X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Child & Adolescent",
            "state": "MO",
            "license": "131115",
            "primary": true
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "MO",
            "license": "131115",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "423952514",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAMELA",
            "last_name": "ASHFORD",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Blue Springs, MO

Sources for this page

Verify at the official NPI Registry.