Stanley Kipkulei, NP
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Trenton, MO
NPI 1962037770 · NPPES record last updated Sep 12, 2024
Key facts
- NPI
- 1962037770
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 2020005871 (MO)
- Practice address
- 1601 E 28TH St
Trenton, MO 64683-1178 - Phone
- (660) 359-4487
- NPI assigned
- Mar 12, 2020
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- North Central Missouri Mental Health Center
Practice addresses (Care Compare)
1601 E 28TH St
Trenton, MO 64683-1178
Phone (660) 359-4487
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MO, IA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200428000540 | MO | Practitioner - Nurse Practitioner | 9830529148 | Reassigns benefits to 1 organization |
| I20220714003679 | IA | Practitioner - Nurse Practitioner | 9830529148 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5379195072 | KS | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Landmark Medical of Tennessee PC | Single Specialty | Current |
Accepting new patients |
| North Central Missouri Mental Health Center | Single Specialty | Current |
Accepting new patients |
| North Central Missouri Mental Health Center | Current |
Accepting new patients | |
| Landmark Medical of Tennessee PC | Single Specialty | Current |
Accepting new patients |
Locations
7755 Center Ave
Ste 630
Huntington Beach, CA 92647
Phone (877) 240-3112
1089 Jordan Creek Pkwy
Ste 200
West Des Moines, IA 50266
Phone (615) 206-2462
1102 W Helm St
Brookfield, MO 64628
Phone (660) 359-4487
401 Youssef Dr
Chillicothe, MO 64601
Phone (660) 359-4487
1601 E 28th St
Trenton, MO 64683
Phone (660) 359-4487
Interoperability endpoints
- skipkulei@landmarkhealth-direct.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 2020005871 | MO | Yes |
| Psychiatric/Mental Health Nurse Practitioner |
363LP0808X | 5379195072 | KS |
Addresses
Primary practice location
1601 E 28TH St
Trenton, MO 64683-1178
Mailing address
11805 Troost Ave
Kansas City, MO 64131-3774
Phone (913) 221-2625
Other practice location 1
10870 Benson Dr Ste 2160
Overland Park, KS 66210-1509
Phone (833) 357-3227
Other practice location 2
11805 Troost Ave
Kansas City, MO 64131-3774
Phone (913) 221-2625
Other practice location 3
9229 Ward Pkwy Ste 380
Kansas City, MO 64114-5471
Phone (816) 319-4785
Other providers in Trenton, MO
- Loryne D Irvine
- J.a. Bowe, M.D., P.C.
- David Alan Jennings
- Jerry A Keuhn
- Melissa D. King
- Michelle Lynn Kraft
- Brooke A Leamer
- Mikaela Ledford
- Craig Lewis
- Gregory Lewis
All providers in Trenton, MO · Psychiatric/Mental Health Nurse Practitioner in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 12, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.