NPIMap

Organization Active NPI

New Liberty Hospital Corporation

Doing business as The Liberty Clinic

  • Family Medicine Physician
  • Liberty, MO
National Provider Identifier
1023360690
Registry record updated Feb 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
NEW LIBERTY HOSPITAL CORPORATION
Doing business as
The Liberty Clinic
Practice address
2609 Glenn Hendren Dr
Liberty, MO 64068-3313
Phone
(816) 781-7730
Fax
(816) 415-1886
NPI assigned
Oct 8, 2012
Last updated
Feb 1, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2018

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

Authorized official

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Pediatrics PhysicianGroup: 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 1

  • The Liberty Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

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

Other NPIs on the same Medicare enrollment 13

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

View all 13

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
26D0443032Liberty Hospital Primary Care Liberty Clinic2609 Glenn Hendren Dr, Liberty, MO 64068ComplianceSep 29, 2027

National Provider Directory

National Provider Directory
Tax ID family
New Liberty Hospital Corporation14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

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

View all 13

Locations

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

2521 Glenn Hendren Dr
Ste 360
Liberty, MO 64068

2609 Glenn Hendren Dr
Ste 108
Liberty, MO 64068

2621 Glenn Hendren Dr Ste 306
Liberty, MO 64068

Practitioners & affiliated clinicians

Practitioners 78

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 78

NPI Registry JSON

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

{
    "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

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.