Individual provider Active NPI

Lori Ann Golon, MD

  • Pediatrics Physician
  • Leavenworth, KS
National Provider Identifier
1114019593
Registry record updated Feb 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
0428097 Issued in KS
Practice address
1001 6TH Ave Ste 210
Leavenworth, KS 66048-3248
Phone
(913) 682-3920
Fax
(913) 682-6239
NPI assigned
Sep 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 0428097 KS Primary

Addresses

Primary practice location

1001 6TH Ave Ste 210
Leavenworth, KS 66048-3248

Mailing address

19800 Metcalf Ave Unit 36
Stilwell, KS 66085-2602
Phone (913) 379-2266

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
I20230724003707 KS Practitioner - Pediatric Medicine 4688034556 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0428097KSMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lori Golon MD PA Pediatrics CurrentSince Feb 9, 2025 Accepting new patients
Swope Health Services CurrentSince Jul 10, 2023 Accepting new patients
Swope Health Services CurrentSince Jul 10, 2023 Accepting new patients
Swope Health Services Current Accepting new patients
Lori Ann Golon MD PA Pediatrics CurrentSince Feb 9, 2025 Accepting new patients
Swope Health Services Past Accepting new patients
Midwest Division-Oprmc LLC Past Accepting new patients

Locations

21 N 12th St
Ste 400
Kansas City, KS 66102
Phone (816) 599-5111

1001 6th Ave
Ste 210
Leavenworth, KS 66048
Phone (913) 682-2424

10500 Quivira Rd
Shawnee Mission, KS 66215
Phone (913) 227-0565

19800 Metcalf Ave
Unit 36
Stilwell, KS 66085

3801 Dr Martin Luther King Jr Blvd
Kansas City, MO 64130
Phone (816) 599-5500

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FCJABA
  • FHIR API: https://fhir4.healow.com/fhir/r4/FBEGDD/Endpoint/FBEGDD

Organizations & group practices 7

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": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738800000000",
    "number": "1114019593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19800 METCALF AVE UNIT 36",
            "city": "STILWELL",
            "state": "KS",
            "postal_code": "660852602",
            "telephone_number": "913-379-2266",
            "fax_number": "877-673-6823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 6TH AVE STE 210",
            "city": "LEAVENWORTH",
            "state": "KS",
            "postal_code": "660483248",
            "telephone_number": "913-682-3920",
            "fax_number": "913-682-6239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLON",
        "first_name": "LORI",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-29",
        "last_updated": "2025-02-06",
        "certification_date": "2025-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KS",
            "license": "0428097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leavenworth, KS

Sources for this page

Verify at the official NPI Registry.