Active NPI
Martin Anthony Kanne, MD
- Family Medicine Physician
- Kansas City, MO
National Provider Identifier
1255301172
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MDR4E89
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11217018 | Other | BCBS 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100724000318 | MO | Practitioner - Family Practice | 6709918840 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MDR4E89 | MO | MD | Family 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.