Individual provider Active NPI

Charles L Weinstein, M.D.

  • Neurology Physician
  • Kansas City, MO
National Provider Identifier
1174565337
Registry record updated Nov 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
R5981 Issued in MO
Practice address
4400 Broadway
Suite 520
Kansas City, MO 64111-3342
Phone
(816) 531-4080
Fax
(816) 531-0281
NPI assigned
Jun 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 04-15070 KS
Neurology Physician 2084N0400X R5981 MO Primary

Addresses

Primary practice location

4400 Broadway
Suite 520
Kansas City, MO 64111-3342

Mailing address

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

Other identifiers 5

IdentifierTypeStateIssuer
100079260CMedicaidKS
100079260DMedicaidKS
04424005OtherBLUE CROSS BLUE SHIELD
200362622MedicaidMO
4002039OtherAETNA

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
I20090619000375 MO Practitioner - Neurology 0345391082 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
04-15070KSMDNeurology Physician
R5981MOMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Lukes Hospital of Chillicothe CurrentSince May 5, 2009 Accepting new patients
Saint Lukes Hospital of Chillicothe CurrentSince May 5, 2009 Accepting new patients
SLNC Inc Neurology Past Accepting new patients
Neurological Consultants of Kansas City, Inc Neurology PastSince Jun 1, 2009 Accepting new patients

Locations

2799 N Washington St
Chillicothe, MO 64601
Phone (660) 214-8300

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

Organizations & group practices 4

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": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510876800000",
    "number": "1174565337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 E 104TH ST",
            "address_2": "MAILSTOP 400S",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "64131",
            "telephone_number": "816-502-7117",
            "fax_number": "816-932-9670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 BROADWAY",
            "address_2": "SUITE 520",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641113342",
            "telephone_number": "816-531-4080",
            "fax_number": "816-531-0281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEINSTEIN",
        "first_name": "CHARLES",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2017-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "KS",
            "license": "04-15070",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MO",
            "license": "R5981",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100079260C",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100079260D",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "04424005",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200362622",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4002039",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.