NICOLE LYNN WICKOREN CRNA
NPI 1104448943
Nurse Anesthetist, Certified Registered in Overland Park, KS

Q: What is Nicole Wickoren's NPI number?

The NPI number for Nicole Wickoren is 1104448943. It was assigned to this individual provider in the NPPES registry on May 14, 2020.

Q: What is Nicole Wickoren's specialty?

The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

Q: When was this NPI record last updated?

The NPPES record for Nicole Wickoren was last updated on April 21, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since May 14, 2020Accepts Medicare Assignment

7820 W 165TH ST, OVERLAND PARK, KS 66223(913) 373-2000(913) 428-2951 Get Directions Write a Review

NPPES record last updated: April 21, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Apr 21, 2026, May 27, 2020, May 21, 2020 and 1 more (4 updates tracked since 2020).

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About Nicole Lynn Wickoren Crna NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NICOLE LYNN WICKOREN CRNA (NPI 1104448943) is an individual nurse anesthetist, certified registered in Overland Park, Kansas, licensed in Kansas (43-557796) and active in the NPI registry since May 2020. She is affiliated with St Mary's Medical Center, maintains a secondary practice location in Kansas City, and is a graduate of Other (2020).

NPPES Registry Identity

NPI1104448943

Entity TypeIndividualFemale

Primary Taxonomy367500000X

Provider Legal NameNICOLE LYNN WICKORENCredential: CRNA

Location Address7820 W 165TH STOverland Park, KS 66223-2925

Mailing Address8717 W 110th St Ste 600Overland Park, KS 66210-2126 · (913) 428-2900 · Fax (913) 428-2951

Phone(913) 373-2000

Fax(913) 428-2951

Sole ProprietorNo

Medical School CMSOtherGraduated 2020

Enumeration DateMay 14, 2020

Last NPPES UpdateApril 21, 20264 updates tracked since enumeration

NPPES CertifiedApril 21, 2026

✔ NPI 1104448943 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code367500000X

Licenses✔ Licensed in KS · 43-557796✔ Licensed in MO · 2020012946

Definition

(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.

Also ListedRegistered NurseTaxonomy 163W00000X · License 2005038282 (MO)

7820 W 165TH ST, Overland Park, KS 66223

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Secondary Practice Location 1

Location 12316 E Meyer BlvdKansas City, MO 64132-1136 · Phone (913) 428-2900 · Fax (913) 428-2951

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter from Sunflower Health Plan, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Nicole Lynn Wickoren Crna is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID42632770

PECOS Enrollment IDI20200625000241, I20200828002776

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

St Mary's Medical Center

Acute Care Hospitals · Blue Springs, MO

4/5 CMS rating

OwnershipProprietary

CMS Certification Number260193

Location201 NW R D Mize RdBlue Springs, MO 64014 · Jackson County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 66223 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$122.41 typical visit price

range $53.00 – $161.67

Typical copayment $30.60 (range $13.25 – $40.41)

Most-billed visit code 99204

Established Patient

$66.40 typical visit price

range $16.88 – $132.11

Typical copayment $16.60 (range $4.22 – $33.02)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CASSIE CHRISTINE DIETRICH M.D.

Anesthesiology