Individual provider Active NPI

Trevor Perdue, APRN-CNP, FNP-C

  • Family Nurse Practitioner
  • Kansas City, MO
National Provider Identifier
1861179129
Registry record updated Jun 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2023025362 Issued in MO
Practice address
7925 NW 110TH St
Kansas City, MO 64153-1288
Phone
(816) 858-2412
NPI assigned
Jun 29, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2023025362 MO Primary

Addresses

Primary practice location

7925 NW 110TH St
Kansas City, MO 64153-1288

Mailing address

7925 NW 110TH St
Kansas City, MO 64153-1288
Phone (816) 858-2412

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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 1

Enrollment IDStateProvider typePAC IDDetails
I20231004003155 MO Practitioner - Nurse Practitioner 6901251321 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Ohio State University College of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Big Tree Medical Group LLCGroup PAC ID 6507232543, 9 clinicians

Practice addresses (Care Compare)

200 Corporate Lake Dr
Columbia, MO 65203-7172
Phone (417) 234-2860

Hospital & facility affiliations

  • University of Missouri Health Care Hospital, Columbia, MO, CCN 260141

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Big Tree Medical Group LLC CurrentSince Aug 6, 2024 Accepting new patients
Little Tree Pediatric Urgent Care LLC Past Accepting new patients

Locations

206 Corporate Lake Dr
Columbia, MO 65203
Phone (573) 814-1170

200 Corporate Lake Dr
Columbia, MO 65203
Phone (417) 234-2860

Interoperability endpoints

  • Direct secure messaging: trevor.perdue@115443077021700.direct.elationemr.com

Organizations & group practices 2

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.

Hospital & facility affiliations 2

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": "1687996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688083200000",
    "number": "1861179129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7925 NW 110TH ST",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641531288",
            "telephone_number": "816-858-2412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7925 NW 110TH ST",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641531288",
            "telephone_number": "816-858-2412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERDUE",
        "first_name": "TREVOR",
        "credential": "APRN-CNP, FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-29",
        "last_updated": "2023-06-30",
        "certification_date": "2023-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2023025362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.