Active NPI
Jennifer Lee Neitzel, D.O.
- Pediatrics Physician
- Liberty, MO
National Provider Identifier
1063685931
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 2009004531
- Practice address
- 1540 NE 96TH Street
Liberty, MO 64068 - Phone
- (816) 412-2900
- Fax
- (816) 412-2915
- NPI assigned
- Apr 10, 2008
- Last updated
- Apr 7, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 2009004531 | MO | Primary |
Addresses
Primary practice location
1540 NE 96TH Street
Liberty, MO 64068
Mailing address
9405 N Oak Trfwy
Kansas City, MO 64155
Phone (918) 232-2487
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 Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2009004531 | MO | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Priority Care Pediatrics, LLC | Pediatrics | Past | Accepting new patients |
| Priority Care Pediatrics, LLC Liberty | Pediatrics | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Pediatrics Physician
- Kansas City, MO
- NPI 1033157664
-
dba Priority Care Pediatrics, LLC
- Pediatrics Physician
- Liberty, MO
- NPI 1801297452
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1207785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1428364800000",
"number": "1063685931",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9405 N OAK TRFWY",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "64155",
"telephone_number": "918-232-2487",
"fax_number": "816-792-3245"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1540 NE 96TH STREET",
"city": "LIBERTY",
"state": "MO",
"postal_code": "64068",
"telephone_number": "816-412-2900",
"fax_number": "816-412-2915"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEITZEL",
"first_name": "JENNIFER",
"middle_name": "LEE",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-04-10",
"last_updated": "2015-04-07",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MO",
"license": "2009004531",
"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 Apr 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.