Individual provider Active NPI

Tamica Titanya Johnson

  • Gerontology Nurse Practitioner
  • Kansas City, MO
National Provider Identifier
1891449013
Registry record updated Feb 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
2021043562 Issued in MO
Practice address
12000 Wornall Rd
Kansas City, MO 64145-1117
Phone
(816) 941-1000
NPI assigned
Feb 7, 2022
Last updated
Feb 7, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 2021043562 MO Primary

Addresses

Primary practice location

12000 Wornall Rd
Kansas City, MO 64145-1117

Mailing address

12000 Wornall Rd
Kansas City, MO 64145-1117
Phone (816) 213-7539

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
I20220318000184 MO Practitioner - Nurse Practitioner 5890180426 Reassigns benefits to 4 organizations
I20220713000831 KS Practitioner - Nurse Practitioner 5890180426 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Complete Health Care Services PAGroup PAC ID 7012199326, 9 clinicians

Practice addresses (Care Compare)

2203 E Mechanic St
Meadowview
Harrisonville, MO 64701-2060
Phone (816) 380-2622

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Louay K. Sabih, LLC CurrentSince Jul 6, 2022 Accepting new patients
Infinite Medical PC CurrentSince Feb 23, 2025 Accepting new patients
Complete Health Care Services PA CurrentSince Jun 1, 2025 Accepting new patients
Altea Medical Missouri LLC CurrentSince Jul 25, 2024 Accepting new patients
Post Acute Medical PLLC CurrentSince Jul 25, 2024 Accepting new patients
Kansas City Hospice, Inc PastSince Feb 13, 2022 Accepting new patients
Kansas City Hospice, Inc PastSince Feb 13, 2022 Accepting new patients
Medical Specialists PA Past Accepting new patients

Locations

400 E Rivulon Blvd
Ste 103
Gilbert, AZ 85297

10550 Marty St
Ste 201
Overland Park, KS 66212

11111 Nall Ave
Ste 103
Overland Park, KS 66211
Phone (888) 778-9471

12100 W 109th St
Shawnee Mission, KS 66210
Phone (913) 469-4210

3430 McKelvey Rd
Ste J
Bridgeton, MO 63044
Phone (314) 551-2101

2203 E Mechanic St
Harrisonville, MO 64701
Phone (615) 497-7460

3001 E Elm St
Harrisonville, MO 64701
Phone (816) 380-6525

2160 SE Blue Pkwy
Lees Summit, MO 64063
Phone (816) 554-0101

430 N West St
Perryville, MO 63775
Phone (273) 547-1011

1441 Charic Dr
Wildwood, MO 63021
Phone (636) 394-2522

250 Skillman St
Ste 202
Brooklyn, NY 11205

Organizations & group practices 8

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": "1644192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644192000000",
    "number": "1891449013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12000 WORNALL RD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641451117",
            "telephone_number": "816-213-7539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12000 WORNALL RD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641451117",
            "telephone_number": "816-941-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "TAMICA",
        "middle_name": "TITANYA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-07",
        "last_updated": "2022-02-07",
        "certification_date": "2022-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MO",
            "license": "2021043562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.