Individual provider Active NPI

Nicole Marshall-Ebersole, APN

  • Adult Health Nurse Practitioner
  • Kansas City, MO
National Provider Identifier
1831501592
Registry record updated May 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
2014010129 Issued in MO
Practice address
2121 Central St Apt 602
Kansas City, MO 64108-2070
Phone
(973) 568-5127
NPI assigned
May 28, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 2014010129 MO Primary
Primary Care Nurse Practitioner 363LP2300X 53-76330-122 KS

Addresses

Primary practice location

2121 Central St Apt 602
Kansas City, MO 64108-2070

Mailing address

2121 Central St Apt 602
Kansas City, MO 64108-2070
Phone (973) 568-5127

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
2014010129MOMDAdult Health Nurse Practitioner
53-76330-122KSMDPrimary Care Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1401235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401235200000",
    "number": "1831501592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 CENTRAL ST APT 602",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641082070",
            "telephone_number": "973-568-5127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 CENTRAL ST APT 602",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641082070",
            "telephone_number": "973-568-5127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL-EBERSOLE",
        "first_name": "NICOLE",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-28",
        "last_updated": "2014-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MO",
            "license": "2014010129",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "KS",
            "license": "53-76330-122",
            "primary": false
        }
    ],
    "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 28, 2014; 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.