Individual provider Active NPI

Diane L Persons, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Kansas City, KS
National Provider Identifier
1063524999
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
40-24711 Issued in KS
Practice address
3901 Rainbow Blvd
Dept of Pathology
Kansas City, KS 66160
Phone
(913) 588-7070
Fax
(913) 588-7073
NPI assigned
Aug 31, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 40-24711 KS Primary

Addresses

Primary practice location

3901 Rainbow Blvd
Dept of Pathology
Kansas City, KS 66160

Mailing address

3901 Rainbow Blvd
4070 Depl Mail Stop 4017
Kansas City, KS 66160-7816
Phone (913) 588-7070

Other identifiers 2

IdentifierTypeStateIssuer
626790OtherKSFIRSTGUARD
22019011OtherMOBCBS KANSAS CITY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
40-24711KSMDAnatomic Pathology & Clinical Pathology Physician

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1063524999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 RAINBOW BLVD",
            "address_2": "4070 DEPL MAIL STOP 4017",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661607816",
            "telephone_number": "913-588-7070",
            "fax_number": "913-588-7073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 RAINBOW BLVD",
            "address_2": "DEPT OF PATHOLOGY",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "66160",
            "telephone_number": "913-588-7070",
            "fax_number": "913-588-7073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERSONS",
        "first_name": "DIANE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "KS",
            "license": "40-24711",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRSTGUARD",
            "identifier": "626790",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS KANSAS CITY",
            "identifier": "22019011",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.