Individual provider Active NPI

Wendell Kevan Clarkston, MD

  • Gastroenterology Physician
  • Kansas City, MO
National Provider Identifier
1144266248
Registry record updated Nov 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
R1732 Issued in MO
Practice address
4320 Wornall Rd
Suite 240
Kansas City, MO 64111-5941
Phone
(816) 932-7940
NPI assigned
Jun 20, 2006
Last updated
Nov 16, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 0429011 KS
Gastroenterology Physician 207RG0100X R1732 MO Primary

Addresses

Primary practice location

4320 Wornall Rd
Suite 240
Kansas City, MO 64111-5941

Mailing address

901 E 104TH St
Mailstop 400
Kansas City, MO 64131
Phone (816) 599-9499

Other identifiers 1

IdentifierTypeStateIssuer
202516639MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, KS2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040331001042 MO Practitioner - Gastroenterology 0446242499 Reassigns benefits to 1 organization
I20100312000449 KS Practitioner - Gastroenterology 0446242499 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
University of Missouri, Kansas City, School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Saint Lukes Physician Group IncGroup PAC ID 3577476894, 1,233 clinicians

Practice addresses (Care Compare)

1001 6TH Ave
Leavenworth, KS 66048-3248

12300 Metcalf Ave
Overland Park, KS 66213-1324
Phone (913) 317-7000

12330 Metcalf Ave
Overland Park, KS 66213-1307

12330 Metcalf Ave
Overland Park, KS 66213-1324

4321 Washington St
Suite 4000
Kansas City, MO 64111-5965
Phone (816) 932-3300

4401 Wornall Rd
Kansas City, MO 64111-3220
Phone (816) 932-3100

5830 NW Barry Rd
Kansas City, MO 64154-2778
Phone (816) 891-3000

601 S 169 Hwy
Smithville, MO 64089-9317
Phone (816) 532-3700

601 S US Hwy 169
Smithville, MO 64089-9317
Phone (816) 532-3999

711 Marshall St
Leavenworth, KS 66048-3235
Phone (913) 684-1100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.56 of 100Reported as group
Quality
76.07
Promoting interoperability
100
Improvement activities
40
Cost
65.79

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy120
Upper gastrointestinal (GI) endoscopy for acid reflux131

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0429011KSMDGastroenterology Physician
R1732MOMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Luke's Physician Group Inc CurrentSince Jan 1, 2018 Accepting new patients
University Health Physicians Gastroenterology Past Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

711 Marshall St
Leavenworth, KS 66048
Phone (913) 684-1100

5405 W 151st St
Leawood, KS 66224
Phone (913) 323-8830

12330 Metcalf Ave
Ste 260
Overland Park, KS 66213
Phone (913) 451-1115

12330 Metcalf Ave
Ste 500A
Overland Park, KS 66213
Phone (913) 323-9000

12300 Metcalf Ave
Shawnee Mission, KS 66213
Phone (913) 317-7000

4320 Wornall Rd
Ste 240
Kansas City, MO 64111
Phone (816) 932-3550

4320 Wornall Rd
Ste 514
Kansas City, MO 64111
Phone (816) 931-1500

4320 Wornall Rd
Ste 65
Kansas City, MO 64111
Phone (816) 932-6100

4321 Washington St
Ste 4000
Kansas City, MO 64111
Phone (816) 932-4549

4401 Wornall Rd
Kansas City, MO 64111
Phone (816) 932-2107

901 E 104th St
Ste 400
Kansas City, MO 64131
Phone (816) 502-8752

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

Interoperability endpoints

  • Direct secure messaging: wclarkston4909@direct.saint-lukes.org

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510790400000",
    "number": "1144266248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 E 104TH ST",
            "address_2": "MAILSTOP 400",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "64131",
            "telephone_number": "816-599-9499",
            "fax_number": "816-932-9670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4320 WORNALL RD",
            "address_2": "SUITE 240",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641115941",
            "telephone_number": "816-932-7940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARKSTON",
        "first_name": "WENDELL",
        "middle_name": "KEVAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-20",
        "last_updated": "2017-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "KS",
            "license": "0429011",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MO",
            "license": "R1732",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "202516639",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.