Individual provider Active NPI

Jonathan Nathanael Wellman, PH.D.

  • Clinical Psychologist
  • Kansas City, MO
National Provider Identifier
1235494022
Registry record updated Nov 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
201635948 Issued in MO
Practice address
4401 Wornall Rd
Kansas City, MO 64111-3220
Phone
(816) 932-2000
NPI assigned
Jul 9, 2012
Sex
Male
Sole proprietor
Yes

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 201635948 MO Primary

Addresses

Primary practice location

4401 Wornall Rd
Kansas City, MO 64111-3220

Mailing address

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

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170731000572 MO Practitioner - Clinical Psychologist 5799055281 Reassigns benefits to 1 organization
I20170908001826 KS Practitioner - Clinical Psychologist 5799055281 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2015
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)

301 NE Mulberry St
Suite 200
Lees Summit, MO 64086-6017
Phone (816) 932-1711

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

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
201635948MOMDClinical Psychologist
2527KSMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Luke'S Physician Group Inc CurrentSince Oct 15, 2017 Accepting new patients

Locations

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

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

12330 Metcalf Ave
Ste 200
Overland Park, KS 66213
Phone (816) 531-4080

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

5844 NW Barry Rd
Ste 110
Kansas City, MO 64154
Phone (816) 880-6100

4400 Broadway Blvd
Ste 407
Kansas City, MO 64111
Phone (816) 931-1711

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

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

Interoperability endpoints

  • Direct secure messaging: jwellman216055@direct.saint-lukes.org

Organizations & group practices 1

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": "1341792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510790400000",
    "number": "1235494022",
    "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": "4401 WORNALL RD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641113220",
            "telephone_number": "816-932-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLMAN",
        "first_name": "JONATHAN",
        "middle_name": "NATHANAEL",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-09",
        "last_updated": "2017-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MO",
            "license": "201635948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.