NPIMap

Organization Active NPI

New Liberty Hospital Coporation

  • Nephrology Physician
  • Liberty, MO
National Provider Identifier
1053284190
Registry record updated Sep 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
NEW LIBERTY HOSPITAL COPORATION
Practice address
2521 Glenn Hendren Dr Ste 202
Liberty, MO 64068-3388
Phone
(816) 415-3470
NPI assigned
Sep 25, 2025
Last updated
Sep 25, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
NEW LIBERTY HOSPITAL COPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 25, 2025

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

Authorized official

Name
John Staton
Title
Chief Operating Officer
Phone
(816) 792-7091

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X Primary

Addresses

Primary practice location

2521 Glenn Hendren Dr Ste 202
Liberty, MO 64068-3388

Mailing address

PO Box 219672
Kansas City, MO 64121-9672

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

National Provider Directory

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

Other organizations with this tax ID 13

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

View all 13

Locations

2521 Glenn Hendren Dr
Ste 200
Liberty, MO 64068
Phone (816) 781-3515

2521 Glenn Hendren Dr
Ste 308
Liberty, MO 64068
Phone (816) 407-5490

2529 Glenn Hendren Dr
Fl 3
Liberty, MO 64068
Phone (816) 792-7229

2529 Glenn Hendren Dr
Ste 108
Liberty, MO 64068
Phone (816) 407-2001

2529 Glenn Hendren Dr
Ste 206
Liberty, MO 64068
Phone (816) 792-7089

2529 Glenn Hendren Dr
Ste G80
Liberty, MO 64068
Phone (816) 415-7990

2609 Glenn Hendren Dr
Liberty, MO 64068
Phone (816) 407-4555

Practitioners & affiliated clinicians

Practitioners 159

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 159

NPI Registry JSON

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

{
    "created_epoch": "1758758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758758400000",
    "number": "1053284190",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2521 GLENN HENDREN DR STE 202",
            "city": "LIBERTY",
            "state": "MO",
            "postal_code": "640683388",
            "telephone_number": "816-415-3470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW LIBERTY HOSPITAL COPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NEW LIBERTY HOSPITAL COPORATION",
        "enumeration_date": "2025-09-25",
        "last_updated": "2025-09-25",
        "certification_date": "2025-09-25",
        "status": "A",
        "authorized_official_last_name": "STATON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "816-792-7091"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Sep 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.