Individual provider Active NPI

Stephanie N Chura, PA-C

  • Medical Physician Assistant
  • Kansas City, MO
National Provider Identifier
1275802191
Registry record updated Oct 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
2015041684 Issued in MO
Practice address
4401 Wornall Rd
Kansas City, MO 64111-3220
Phone
(816) 932-3300
Fax
(816) 932-5793
NPI assigned
Dec 21, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 15-01501 KS
Medical Physician Assistant 363AM0700X 2015041684 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) 932-3300

Other names 1

  • Stephanie N Dumolt Former name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151203001237 MO Practitioner - Physician Assistant 0244498202 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
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)

4401 Wornall Rd
Kansas City, MO 64111-3220
Phone (816) 932-3100

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

Hospital & facility affiliations

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
Physician Assistant

State licenses

LicenseStateTypeSpecialty
15-01501KSMDMedical Physician Assistant
2015041684MOMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Lukes Physician Group Inc CurrentSince Jan 1, 2018 Accepting new patients
Saint Luke'S Physician Group Inc CurrentSince Jan 1, 2018 Accepting new patients
Saint Lukes Physician Group II LLC Past Accepting new patients

Locations

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

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

4321 Washington St
Ste 4000
Kansas City, MO 64111
Phone (816) 932-4549

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

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

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 and National Provider Directory roles.

Hospital & facility affiliations 7

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": "1324425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697155200000",
    "number": "1275802191",
    "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": "816-932-3300",
            "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": "816-932-3300",
            "fax_number": "816-932-5793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHURA",
        "first_name": "STEPHANIE",
        "middle_name": "N",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-21",
        "last_updated": "2023-10-13",
        "certification_date": "2023-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "KS",
            "license": "15-01501",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MO",
            "license": "2015041684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "DUMOLT",
            "middle_name": "N",
            "credential": "P.A.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.