Individual provider Active NPI

Lydia Muttai, APRN

  • Adult Health Nurse Practitioner
  • Overland Park, KS
National Provider Identifier
1831514660
Registry record updated Mar 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
76272 Issued in KS
Practice address
11661 College Blvd
Overland Park, KS 66210-4107
Phone
(913) 432-8400
Fax
(913) 432-8402
NPI assigned
Mar 4, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 76272 KS Primary

Addresses

Primary practice location

11661 College Blvd
Overland Park, KS 66210-4107

Mailing address

11661 College Blvd
Overland Park, KS 66210-4107
Phone (913) 432-8400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS, MO, IA3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20150506002218 KS Practitioner - Nurse Practitioner 2860711249 Reassigns benefits to 2 organizations
I20180608000150 MO Practitioner - Nurse Practitioner 2860711249 Reassigns benefits to 1 organization
I20240214000984 IA Practitioner - Nurse Practitioner 2860711249 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health Medical Associates of Kansas LLC CurrentSince Jul 2, 2023 Accepting new patients
Signify Health Medical Associates, PLLC CurrentSince Jan 11, 2024 Accepting new patients
Emergent Care Plus of Overland Park, LLC CurrentSince Jun 12, 2019 Accepting new patients
Signify Health, LLC CurrentSince Jan 28, 2024 Accepting new patients
Carespot Professional Services LLC PastSince Aug 4, 2015 Accepting new patients
Emergent Care Plus, LLC Past Accepting new patients

Locations

400 E Court Ave
Ste 110
Des Moines, IA 50309

1100 N 4th St
Leavenworth, KS 66048
Phone (913) 297-9945

2300 Main St
Fl 9
Kansas City, MO 64108
Phone (800) 416-1767

120 S Central Ave
Saint Louis, MO 63105
Phone (314) 201-6459

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Interoperability endpoints

  • Direct secure messaging: lydia.muttai.1@14940.direct.athenahealth.com

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1393891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393891200000",
    "number": "1831514660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11661 COLLEGE BLVD",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662104107",
            "telephone_number": "913-432-8400",
            "fax_number": "913-432-8402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11661 COLLEGE BLVD",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662104107",
            "telephone_number": "913-432-8400",
            "fax_number": "913-432-8402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUTTAI",
        "first_name": "LYDIA",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-04",
        "last_updated": "2014-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "KS",
            "license": "76272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

Verify at the official NPI Registry.