Active NPI
Mahmuda Nasrin
- Family Medicine Physician
- Grandview, MO
National Provider Identifier
1972235349
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 2022010189
- Practice address
- 13013 Fuller Ave Ste a
Grandview, MO 64030-2687 - Phone
- (816) 509-6694
- NPI assigned
- Jun 25, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 2022010189 | MO | Primary |
Addresses
Primary practice location
13013 Fuller Ave Ste a
Grandview, MO 64030-2687
Mailing address
13013 Fuller Ave Ste a
Grandview, MO 64030-2687
Phone (816) 509-6694
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2022010189 | MO | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1656115200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656115200000",
"number": "1972235349",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13013 FULLER AVE STE A",
"city": "GRANDVIEW",
"state": "MO",
"postal_code": "640302687",
"telephone_number": "816-509-6694"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13013 FULLER AVE STE A",
"city": "GRANDVIEW",
"state": "MO",
"postal_code": "640302687",
"telephone_number": "816-509-6694"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NASRIN",
"first_name": "MAHMUDA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-06-25",
"last_updated": "2022-06-25",
"certification_date": "2022-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MO",
"license": "2022010189",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grandview, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.