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DERRICK PAUL HEATHERLY LPN
NPI 1336946714
Licensed Practical Nurse in Kansas City, MO

Active since February 25, 2025
4251 NORTHERN AVE, KANSAS CITY, MO 64133(816) 861-4700 Get Directions Write a Review

NPPES record last updated: February 25, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Derrick Paul Heatherly Lpn NPPES

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

DERRICK PAUL HEATHERLY LPN (NPI 1336946714) is an individual licensed practical nurse in Kansas City, Missouri, licensed in Missouri (2001027589) and active in the NPI registry since February 2025.

NPPES Registry Identity

NPI1336946714
Entity TypeIndividualMale
Primary Taxonomy164W00000X
Provider Legal NameDERRICK PAUL HEATHERLYCredential: LPN
Location Address4251 NORTHERN AVEKansas City, MO 64133-1593
Mailing Address601 Ne 2nd StBlue Springs, MO 64014-2903 · (816) 933-3663
Phone(816) 861-4700
Sole ProprietorYes
Enumeration DateFebruary 25, 2025
NPPES CertifiedFebruary 25, 2025
✔ NPI 1336946714 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyLicensed Practical NurseNursing Service Providers
Taxonomy Code164W00000X
License✔ Licensed in MO · 2001027589
Definition
A licensed practical nurse with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.
4251 NORTHERN AVE, Kansas City, MO 64133
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Other Providers at the Same Location NPPES 20

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

DAXTEN PRUTER NURSE PRACTITIONER
Nurse Practitioner (Family)
4251 NORTHERN AVE
KANSAS CITY, MO 64133
Jackson County (181) 686-1470
SASHA ELLEN CART RN
Registered Nurse (Psychiatric/Mental Health)
4251 NORTHERN AVE
KANSAS CITY, MO 64133
Jackson County (816) 728-1396
JOSHUA SIMONIS RN
Registered Nurse
4251 NORTHERN AVE
KANSAS CITY, MO 64133
Jackson County (816) 922-2338
MRS. PATRICIA A. HARVEY RN, BSN
Registered Nurse
4251 NORTHERN AVE
KANSAS CITY, MO 64133
Jackson County (816) 922-2845
KARA ANN STANLEY
Registered Nurse (Psychiatric/Mental Health)
4251 NORTHERN AVE
KANSAS CITY, MO 64133
Jackson County (816) 769-0103
SAVITRI MANDA M.D.
Family Medicine
4251 NORTHERN AVE
KANSAS CITY, MO 64133
Jackson County (816) 922-2366
DR. LLOYD BERNARD BLEDSOE M.D.
Family Medicine
4251 NORTHERN AVE
KANSAS CITY, MO 64133
Jackson County (816) 861-4700
SUDHIR HEGDE M.D., PH.D.
Internal Medicine
4251 NORTHERN AVE
KANSAS CITY, MO 64133
Jackson County (816) 861-4700

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Derrick Heatherly's NPI number?

The NPI number for Derrick Heatherly is 1336946714. It was assigned to this individual provider in the NPPES registry on February 25, 2025.

Where is Derrick Heatherly located?

Derrick Heatherly practices at 4251 Northern Ave, Kansas City, MO 64133. The listed phone number is (816) 861-4700.

What is Derrick Heatherly's specialty?

The primary specialty registered for this NPI is Licensed Practical Nurse with taxonomy code 164W00000X.

When was this NPI record last updated?

The NPPES record for Derrick Heatherly was last updated on February 25, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.