Individual provider Active NPI

Terry D Suppes, DO

  • Family Medicine Physician
  • Kansas City, MO
National Provider Identifier
1194763524
Registry record updated Jul 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
36974 Issued in MO
Practice address
6675 Holmes Rd
Suite 360
Kansas City, MO 64131-1150
Phone
(816) 276-7600
Fax
(816) 276-7992
NPI assigned
Jun 4, 2006
Last updated
Jul 11, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 36974 MO Primary

Addresses

Primary practice location

6675 Holmes Rd
Suite 360
Kansas City, MO 64131-1150

Mailing address

6675 Holmes Rd
Suite 450
Kansas City, MO 64131-1150
Phone (816) 276-7600

Other identifiers 3

IdentifierTypeStateIssuer
243112612MedicaidMO
P00121096OtherMOMEDICARE RAILROAD
100234880CMedicaidKS

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
I20040618001296 MO Practitioner - Family PracticePractitioner - Geriatric Medicine 9830174457 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Geriatric Medicine
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Goppert - Trinity Family Care, LLCGroup PAC ID 8426956681, 10 clinicians

Practice addresses (Care Compare)

6675 Holmes Rd
Suite 360
Kansas City, MO 64131-1167
Phone (816) 276-7600

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36974MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Goppert - Trinity Family Care, LLC Family Medicine CurrentSince Apr 1, 2003 Accepting new patients
Midwest Division - RMC, LLC Past Accepting new patients
HCA Physician Services Past Accepting new patients

Locations

6675 Holmes Rd
Ste 360
Kansas City, MO 64131
Phone (816) 276-7650

6675 Holmes Rd
Ste 450
Kansas City, MO 64131
Phone (816) 276-7650

Interoperability endpoints

  • Direct secure messaging: terry.suppes@hca2.eclinicaldirectplus.com

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 1

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": "1149379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373500800000",
    "number": "1194763524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6675 HOLMES RD",
            "address_2": "SUITE 450",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641311150",
            "telephone_number": "816-276-7600",
            "fax_number": "816-276-7090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6675 HOLMES RD",
            "address_2": "SUITE 360",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641311150",
            "telephone_number": "816-276-7600",
            "fax_number": "816-276-7992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUPPES",
        "first_name": "TERRY",
        "middle_name": "D",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-04",
        "last_updated": "2013-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "36974",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "243112612",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00121096",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100234880C",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.