NPIMap

Individual provider Active NPI

Johnna K. Wilcox, MD

  • Family Medicine Physician
  • Platte City, MO
National Provider Identifier
1205890811
Registry record updated Oct 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2500064694 Issued in MO
Practice address
2703 Running Horse Rd
Platte City, MO 64079-7707
Phone
(816) 858-7050
Fax
(816) 858-7055
NPI assigned
Apr 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2023

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 2500064694 MO Primary

Addresses

Primary practice location

2703 Running Horse Rd
Platte City, MO 64079-7707

Mailing address

2703 Running Horse Rd
Platte City, MO 64079-7707
Phone (816) 858-7050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, MO2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100913001186 WA Practitioner - Family Practice 1153446265 Reassigns benefits to 1 organization
I20230818000346 MO Practitioner - Family Practice 1153446265 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Missouri, Kansas City, School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Lukes Physician Group IncGroup PAC ID 3577476894, 1,233 clinicians

Practice addresses (Care Compare)

2703 Running Horse Rd
Platte City, MO 64079-7707
Phone (816) 858-7050

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2500064694MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Public Hospital Dist No 1 Skagit CurrentSince Jul 1, 2010 Accepting new patients
Public Hospital Dist No 1 Skagit CurrentSince Jul 1, 2010 Accepting new patients
Public Hospital Dist No 1 Skagit Current Accepting new patients
Saint Luke's Physician Group Inc Family Medicine CurrentSince Aug 28, 2023 Accepting new patients
Liberty Hospital Physician Clinics Family Medicine Past Accepting new patients

Locations

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

2703 Running Horse Rd
Platte City, MO 64079
Phone (816) 858-3250

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

1400 E Kincaid St
Mount Vernon, WA 98274
Phone (360) 428-2586

9631 269th St NW
Stanwood, WA 98292
Phone (360) 629-1600

Interoperability endpoints

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

Organizations & group practices 5

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": "1144800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696291200000",
    "number": "1205890811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2703 RUNNING HORSE RD",
            "city": "PLATTE CITY",
            "state": "MO",
            "postal_code": "640797707",
            "telephone_number": "816-858-7050",
            "fax_number": "816-858-7055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2703 RUNNING HORSE RD",
            "city": "PLATTE CITY",
            "state": "MO",
            "postal_code": "640797707",
            "telephone_number": "816-858-7050",
            "fax_number": "816-858-7055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILCOX",
        "first_name": "JOHNNA",
        "middle_name": "K.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-12",
        "last_updated": "2023-10-03",
        "certification_date": "2023-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2500064694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Platte City, MO

Sources for this page

Verify at the official NPI Registry.