Individual provider Active NPI

Dua K Siam, APRN-FNP-CC

  • Family Nurse Practitioner
  • Independence, MO
National Provider Identifier
1871726638
Registry record updated Oct 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5374954031 Issued in KS
Practice address
Take Care Health Missouri, P.C
3915 South Noland Road
Independence, MO 64055-3346
Phone
(855) 925-4733
NPI assigned
Aug 27, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2018

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 5374954031 KS Primary

Addresses

Primary practice location

Take Care Health Missouri, P.C
3915 South Noland Road
Independence, MO 64055-3346

Mailing address

22700 W 55TH Ter
Shawnee, KS 66226-5602
Phone (913) 345-8404

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5374954031KSMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1251331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539216000000",
    "number": "1871726638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22700 W 55TH TER",
            "city": "SHAWNEE",
            "state": "KS",
            "postal_code": "662265602",
            "telephone_number": "913-345-8404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "TAKE CARE HEALTH MISSOURI, P.C",
            "address_2": "3915 SOUTH NOLAND ROAD",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640553346",
            "telephone_number": "855-925-4733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIAM",
        "first_name": "DUA",
        "middle_name": "K",
        "name_prefix": "Ms.",
        "credential": "APRN-FNP-CC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-27",
        "last_updated": "2018-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "5374954031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Independence, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2018; 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.