Individual provider Active NPI

Robert T. Reynders, D.O.

  • Hospice and Palliative Medicine (Psychiatry & Neurology) Physician
  • Kansas City, KS
National Provider Identifier
1063774032
Registry record updated Apr 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084H0002X
License
05-39130 Issued in KS
Practice address
3901 Rainbow Blvd
Ms 1020
Kansas City, KS 66160-8500
Phone
(913) 588-3807
NPI assigned
Jun 14, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 7, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 9407978 KS
Hospice and Palliative Medicine (Psychiatry & Neurology) Physician 2084H0002X 05-39130 KS Primary

Addresses

Primary practice location

3901 Rainbow Blvd
Ms 1020
Kansas City, KS 66160-8500

Mailing address

3901 Rainbow Blvd
Ms 1020
Kansas City, KS 66160-8500
Phone (913) 588-3807

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160318001590 KS Order and Referring Only - NeurologyPractitioner - Neurology 6709183767

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
05-39130KSMDHospice and Palliative Medicine (Psychiatry & Neurology) Physician
9407978KSMDNeurology Physician

NPI Registry JSON

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

{
    "created_epoch": "1339632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491523200000",
    "number": "1063774032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 RAINBOW BLVD",
            "address_2": "MS 1020",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661608500",
            "telephone_number": "913-588-3807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 RAINBOW BLVD",
            "address_2": "MS 1020",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661608500",
            "telephone_number": "913-588-3807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNDERS",
        "first_name": "ROBERT",
        "middle_name": "T.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-06-14",
        "last_updated": "2017-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "KS",
            "license": "9407978",
            "primary": false
        },
        {
            "code": "2084H0002X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Hospice and Palliative Medicine",
            "state": "KS",
            "license": "05-39130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, KS

Sources for this page

Verify at the official NPI Registry.