Individual provider Active NPI

Johann Anton Luckhoff, M.D.

  • Pediatrics Physician
  • Kansas City, MO
National Provider Identifier
1083078950
Registry record updated Jun 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
2019025548 Issued in MO
Practice address
2401 Gillham Rd
Kansas City, MO 64108-4619
Phone
(816) 234-3000
Fax
(816) 302-9939
NPI assigned
Apr 7, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 8, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 04-42335 KS
Pediatrics Physician 208000000X 2019025548 MO Primary

Addresses

Primary practice location

2401 Gillham Rd
Kansas City, MO 64108-4619

Mailing address

901 E 104TH St
Kansas City, MO 64131-4517
Phone (816) 765-6600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20200322000125 MO Practitioner - Pediatric Medicine 9234426032 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
04-42335KSMDPediatrics Physician
2019025548MOMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Luke'S Physician Group Inc CurrentSince Apr 6, 2020 Accepting new patients

Locations

901 E 104th St
Kansas City, MO 64131
Phone (816) 502-7117

901 E 104th St
#400S
Kansas City, MO 64131
Phone (816) 502-7117

2401 Gillham Rd
Kansas City, MO 64108
Phone (816) 234-3380

10918 Elm Ave
Kansas City, MO 64134
Phone (816) 765-6600

5844 NW Barry Rd
Ste 110
Kansas City, MO 64154
Phone (816) 880-6100

10918 Elm Ave
Ste 102
Kansas City, MO 64134
Phone (816) 765-6600

601 S US Highway 169
Smithville, MO 64089
Phone (816) 532-3999

Interoperability endpoints

  • Direct secure messaging: jluckhoff384463@direct.saint-lukes.org

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1459987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591574400000",
    "number": "1083078950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 E 104TH ST",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641314517",
            "telephone_number": "816-765-6600",
            "fax_number": "816-767-4107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 GILLHAM RD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641084619",
            "telephone_number": "816-234-3000",
            "fax_number": "816-302-9939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCKHOFF",
        "first_name": "JOHANN",
        "middle_name": "ANTON",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-07",
        "last_updated": "2020-06-08",
        "certification_date": "2020-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KS",
            "license": "04-42335",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2019025548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.