Grace Nicole Llewellyn, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2019003968 Issued in MO

Practice address

1131 W Kansas St
Liberty, MO 64068-2281

Phone

(816) 287-8144

NPI assigned

Feb 6, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Boulware Medical Clinic L.L.C.

  • Internal Medicine Physician
  • Liberty, MO
  • NPI 1548462799
  Medicare reassignment

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

{
    "created_epoch": "1549411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549411200000",
    "number": "1972068674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4040 N HARDESTY AVE",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641172026",
            "telephone_number": "402-515-5233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1131 W KANSAS ST",
            "city": "LIBERTY",
            "state": "MO",
            "postal_code": "640682281",
            "telephone_number": "816-287-8144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LLEWELLYN",
        "first_name": "GRACE",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-06",
        "last_updated": "2019-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2019003968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maxwell Jay Lindgren
• Kimberly Ann Littlejohn, OTR
• Marlene Annette Littleton, LCSW
• Live Forward
• Eric S Livingston, DDS
• Teadora Locke
• Michael B Loggan, M.D.
• Kali Ann Long
• Brianna Jean Lopez
• Danielle Lorenzo

• Family Nurse Practitioner in Liberty, MO
• Providers in Liberty, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.