Individual provider Active NPI

Martin Anthony Kanne, MD

  • Family Medicine Physician
  • Kansas City, MO
National Provider Identifier
1255301172
Registry record updated Oct 22, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MDR4E89 Issued in MO
Practice address
9411 N Oak Trfy
Suite 100
Kansas City, MO 64155-2262
Phone
(816) 436-1800
Fax
(816) 436-4241
NPI assigned
Jan 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2007

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 MDR4E89 MO Primary

Addresses

Primary practice location

9411 N Oak Trfy
Suite 100
Kansas City, MO 64155-2262

Mailing address

9411 N Oak Trfy
Suite LL1
Kansas City, MO 64155-2262
Phone (816) 436-7073

Other identifiers 1

IdentifierTypeStateIssuer
11217018OtherBCBS OF KC INDIVIDUAL #

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
I20100724000318 MO Practitioner - Family Practice 6709918840

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MDR4E89MOMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1138060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193011200000",
    "number": "1255301172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9411 N OAK TRFY",
            "address_2": "SUITE LL1",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641552262",
            "telephone_number": "816-436-7073",
            "fax_number": "716-436-2743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9411 N OAK TRFY",
            "address_2": "SUITE 100",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641552262",
            "telephone_number": "816-436-1800",
            "fax_number": "816-436-4241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANNE",
        "first_name": "MARTIN",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-24",
        "last_updated": "2007-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "MDR4E89",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF KC INDIVIDUAL #",
            "identifier": "11217018",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.