Ellen Jean Bolton, RD LD
Individual provider Active NPI Registered Dietitian · Olathe, KS
NPI 1124183090 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1124183090
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- 1062 (KS)
- Practice address
- 20333 W 151St St
Olathe, KS 66061-5350 - Phone
- (913) 791-4271
- NPI assigned
- Dec 22, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Registered Dietitian Or Nutrition Professional
- Education
- Other, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Saint Lukes Physician Group Inc
Practice addresses (Care Compare)
12330 Metcalf Ave
Suite 500a
Overland Park, KS 66213-1324
Phone (913) 317-3170
4321 Washington
6100 Saint Luke'S Endocrinology and Diabetes
Kansas City, MO 64111-5928
Phone (816) 932-3470
Merit-based Incentive Payment System (MIPS)
- Final score
- 82.56 of 100
- Quality
- 76.07
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 65.79
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in KS, MO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070219000724 | KS | Practitioner - Registered Dietitian Or Nutrition Professional | 2961504105 | Reassigns benefits to 1 organization |
| I20180731000340 | MO | Practitioner - Registered Dietitian Or Nutrition Professional | 2961504105 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1062 | KS | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Saint Luke'S Physician Group Inc | Current |
Accepting new patients |
Locations
12541 Foster St
Ste 240
Overland Park, KS 66213
Phone (913) 317-3170
12330 Metcalf Ave
Ste 500A
Overland Park, KS 66213
Phone (913) 323-9000
901 E 104th St
Stop 400N
Kansas City, MO 64131
4321 Washington St
Ste 6100
Kansas City, MO 64111
Phone (816) 932-2707
901 E 104th St
#400N
Kansas City, MO 64131
Phone (816) 502-8756
4321 Washington St
Ste 3000
Kansas City, MO 64111
Phone (816) 932-3100
20 NE Saint Lukes Blvd
Ste 200
Lees Summit, MO 64086
Phone (816) 347-5100
601 S US Highway 169
Smithville, MO 64089
Phone (816) 532-3999
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 1062 | KS | Yes |
Addresses
Primary practice location
20333 W 151St St
Olathe, KS 66061-5350
Mailing address
18310 W 116TH St
Olathe, KS 66061-6552
Phone (913) 888-2714
Other providers in Olathe, KS
- Jason Nicholas Bohn
- Mackenzie Bohn
- William W Bohn
- Jamie Lyn Boice
- Steven Alan Bolin
- Janna Renee Bergquist Bolton
- Melodi Bona
- Mark William Bonds
- Robert Scott Bonebrake
- Isaac Bonk
All providers in Olathe, KS · Registered Dietitian in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.