Individual provider Active NPI

Nicholas Robert Isom, M.D.

  • Interventional Cardiology Physician
  • Shawnee Mission, KS
National Provider Identifier
1972950004
Registry record updated Mar 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
04-41836 Issued in KS
Practice address
9119 W 74TH St Ste 350
Shawnee Mission, KS 66204-2268
Phone
(913) 632-9400
Fax
(913) 632-9444
NPI assigned
May 18, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X 04-41836 KS Primary
Cardiovascular Disease Physician 207RC0000X 04-41836 KS

Addresses

Primary practice location

9119 W 74TH St Ste 350
Shawnee Mission, KS 66204-2268

Mailing address

9119 W 74TH St Ste 350
Merriam, KS 66204-2268
Phone (913) 632-9400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190717001448 KS Practitioner - Interventional CardiologyPractitioner - Internal Medicine 3375838139 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional Cardiology
Education
University of Oklahoma College of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

9100 W 74TH St
Ahmg Cardiology at Shawnee Mission
Merriam, KS 66204-4004
Phone (913) 676-2000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting12

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
04-41836KSMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Shawnee Mission Medical Center Inc Internal Medicine CurrentSince Jul 29, 2024 Accepting new patients

Locations

7315 E Frontage Rd
Ste 206
Merriam, KS 66204
Phone (913) 789-3938

9301 W 74th St
Ste 100
Shawnee Mission, KS 66204
Phone (913) 632-9100

9100 W 74th St
Shawnee Msn, KS 66204
Phone (913) 632-2230

9119 W 74th St
Ste 350
Shawnee Msn, KS 66204
Phone (913) 632-9400

Interoperability endpoints

  • Direct secure messaging: nisom3540286@adventhealth.direct-ci.com

Organizations & group practices 1

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1463529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743033600000",
    "number": "1972950004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9119 W 74TH ST STE 350",
            "city": "MERRIAM",
            "state": "KS",
            "postal_code": "662042268",
            "telephone_number": "913-632-9400",
            "fax_number": "913-632-9444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9119 W 74TH ST STE 350",
            "city": "SHAWNEE MISSION",
            "state": "KS",
            "postal_code": "662042268",
            "telephone_number": "913-632-9400",
            "fax_number": "913-632-9444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISOM",
        "first_name": "NICHOLAS",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-18",
        "last_updated": "2025-03-27",
        "certification_date": "2025-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "KS",
            "license": "04-41836",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "KS",
            "license": "04-41836",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shawnee Mission, KS

Sources for this page

Verify at the official NPI Registry.