NPIMap

Individual provider Active NPI

Jay A Lednicky, M.D.

  • Internal Medicine Physician
  • Overland Park, KS
National Provider Identifier
1134112048
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
04-31905 Issued in KS
Practice address
10901 Granada LN
#200
Overland Park, KS 66211-1401
Phone
(913) 660-1616
Fax
(913) 660-1664
NPI assigned
Aug 25, 2005
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X R7H48 MO
Internal Medicine Physician 207R00000X 04-31905 KS Primary

Addresses

Primary practice location

10901 Granada LN
#200
Overland Park, KS 66211-1401

Mailing address

10901 Granada LN
Overland Park, KS 66211-1401
Phone (913) 660-1616

Other identifiers 2

IdentifierTypeStateIssuer
13988062OtherBCBS
4103158OtherAETNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
04-31905KSMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Hospital Specialists, P.a. Internal Medicine Past Accepting new patients
Liberty Hospital Physician Clinics Internal Medicine Past Accepting new patients
The Liberty Clinic, Inc. Internal Medicine Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1124928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1134112048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10901 GRANADA LN",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662111401",
            "telephone_number": "913-660-1616",
            "fax_number": "913-660-1664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10901 GRANADA LN",
            "address_2": "#200",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662111401",
            "telephone_number": "913-660-1616",
            "fax_number": "913-660-1664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEDNICKY",
        "first_name": "JAY",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-25",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "R7H48",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KS",
            "license": "04-31905",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "13988062",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4103158",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.