NPIMap

New Liberty Hospital Corporation

Organization Active NPI Family Medicine Physician · Liberty, MO

NPI 1023360690 · NPPES record last updated Feb 1, 2018

Key facts

NPI
1023360690
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
Legal business name
NEW LIBERTY HOSPITAL CORPORATION
Practice address
2609 Glenn Hendren Dr
Liberty, MO 64068-3313
Phone
(816) 781-7730
Fax
(816) 415-1886
NPI assigned
Oct 8, 2012
Organization subpart
No

Authorized official

Name
Mr. David H Feess
Title
President & Ceo
Phone
(816) 781-7200

Other NPIs on the same Medicare enrollment 13

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Corporate family (same tax ID) 13

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 78

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 78

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
26D0443032Liberty Hospital Primary Care Liberty Clinic
2609 Glenn Hendren Dr, Liberty, MO 64068		ComplianceSep 29, 2027

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MO

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20120918000321 MO Part B Supplier - Clinic/Group Practice 9931166618 Receives reassigned benefits from 161 practitioners
14 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Liberty, MO; Richmond, MO; Plattsburg, MO; Bethany, MO; Excelsior Springs, MO; Kansas City, MO; Kearney, MO

National Provider Directory

Tax ID family
New Liberty Corporation (14 organizations share this tax ID)

Locations

8300 N Church Rd
Kansas City, MO 64158
Phone (816) 407-2300

305 S Platte Clay Way
Ste A
Kearney, MO 64060
Phone (816) 628-4409

2609 Glenn Hendren Dr
Ste 108
Liberty, MO 64068

2521 Glenn Hendren Dr
Ste 360
Liberty, MO 64068

2621 Glenn Hendren Dr Ste 306
Liberty, MO 64068

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207Q00000X Yes
Internal Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207R00000X
Pediatrics Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 208000000X

Addresses

Primary practice location

2609 Glenn Hendren Dr
Liberty, MO 64068-3313

Mailing address

PO Box 219672
Kansas City, MO 64121-9672
Phone (816) 781-7730

Other names

  • The Liberty Clinic Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 1, 2018.

{
    "created_epoch": "1349654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1517443200000",
    "number": "1023360690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 219672",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641219672",
            "telephone_number": "816-781-7730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2609 GLENN HENDREN DR",
            "city": "LIBERTY",
            "state": "MO",
            "postal_code": "640683313",
            "telephone_number": "816-781-7730",
            "fax_number": "816-415-1886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW LIBERTY HOSPITAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-08",
        "last_updated": "2018-02-01",
        "status": "A",
        "authorized_official_last_name": "FEESS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "816-781-7200",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Liberty Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Liberty, MO

All providers in Liberty, MO · Family Medicine Physician in Missouri

Sources for this page

Verify at the official NPI Registry.