NPIMap

Organization Active NPI

Clay Platte Family Medicine Clinic

  • Family Medicine Physician
  • Kansas City, MO
National Provider Identifier
1073570487
Registry record updated Oct 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CLAY PLATTE FAMILY MEDICINE CLINIC
Practice address
5501 NW 62ND Ter Ste 100
Kansas City, MO 64151-2412
Phone
(816) 842-4440
Fax
(816) 842-1974
NPI assigned
Apr 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2022

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

Authorized official

Name
Dr. Scott H Kuennen, M.D.NPI 1972560324
Title
President
Phone
(816) 842-4440

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

5501 NW 62ND Ter Ste 100
Kansas City, MO 64151-2412

Mailing address

5501 NW 62ND Ter Ste 100
Kansas City, MO 64151-2412
Phone (816) 842-4440

Other identifiers 1

IdentifierTypeStateIssuer
505360107MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040120000899 MO Part B Supplier - Clinic/Group Practice 3173424231 Receives reassigned benefits from 25 practitioners
Practice locations: Lees Summit, MO; Liberty, MO; Kansas City, MO
O20100930029257 MO DME Supplier - Physician - Family Practice 3173424231 Practice locations: Kansas City, MO

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
26D0898415Clay-Platte Family Medicine Clinic PC5501 NW 62ND Terrace, Ste 100, Kansas City, MO 64151AccreditationDec 13, 2027

National Provider Directory

National Provider Directory

Locations

3601 NE Ralph Powell Rd
Ste C
Lees Summit, MO 64064
Phone (816) 285-5053

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/032e9fee-d494-4ca3-97ce-b40c8d2eecf6/

Practitioners & affiliated clinicians

Practitioners 25

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1146182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666656000000",
    "number": "1073570487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5501 NW 62ND TER STE 100",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641512412",
            "telephone_number": "816-842-4440",
            "fax_number": "816-842-1974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5501 NW 62ND TER STE 100",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641512412",
            "telephone_number": "816-842-4440",
            "fax_number": "816-842-1974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLAY PLATTE FAMILY MEDICINE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-28",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-25",
        "status": "A",
        "authorized_official_last_name": "KUENNEN",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "816-842-4440",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "505360107",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2022; 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.