Active NPI
Julie Leber Kjorvestad, D.O.
- Internal Medicine Physician
- Raymore, MO
National Provider Identifier
1285052548
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 2019024517
- Practice address
- 501 N Sunset LN
Raymore, MO 64083-9402 - Phone
- (844) 853-8937
- NPI assigned
- Apr 3, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 2019024517 | MO | |
| Psychiatry Physician | 2084P0800X | 05-40078 | KS | |
| Internal Medicine Physician | 207R00000X | 2019024517 | MO | Primary |
| Internal Medicine Physician | 207R00000X | 05-40078 | KS |
Addresses
Primary practice location
501 N Sunset LN
Raymore, MO 64083-9402
Mailing address
1800 Community
Clinton, MO 64735-8804
Phone (660) 885-8131
Other practice location 1
102 Compass Point Dr
Saint Charles, MO 63301-4404
Phone (888) 403-1071
Other practice location 2
901 NE Independence Ave
Lees Summit, MO 64086-5544
Phone (844) 853-8937
Other practice location 3
101 Hospital Dr
Osceola, MO 64776-9547
Phone (888) 403-1071
Other names 1
- Julie Elizabeth Leber
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05-40078 | KS | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1396483200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1626307200000",
"number": "1285052548",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1800 COMMUNITY",
"city": "CLINTON",
"state": "MO",
"postal_code": "647358804",
"telephone_number": "660-885-8131"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 N SUNSET LN",
"city": "RAYMORE",
"state": "MO",
"postal_code": "640839402",
"telephone_number": "844-853-8937"
}
],
"practiceLocations": [
{
"address_1": "102 Compass Point Dr",
"address_purpose": "LOCATION",
"city": "Saint Charles",
"state": "MO",
"postal_code": "633014404",
"country_code": "US",
"telephone_number": "888-403-1071",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "901 NE Independence Ave",
"address_purpose": "LOCATION",
"city": "Lees Summit",
"state": "MO",
"postal_code": "640865544",
"country_code": "US",
"telephone_number": "844-853-8937",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "101 Hospital Dr",
"address_purpose": "LOCATION",
"city": "Osceola",
"state": "MO",
"postal_code": "647769547",
"country_code": "US",
"telephone_number": "888-403-1071",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KJORVESTAD",
"first_name": "JULIE",
"middle_name": "LEBER",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-04-03",
"last_updated": "2021-07-15",
"certification_date": "2021-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MO",
"license": "2019024517",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "KS",
"license": "05-40078",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MO",
"license": "2019024517",
"primary": true
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "KS",
"license": "05-40078",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JULIE",
"last_name": "LEBER",
"middle_name": "ELIZABETH",
"credential": "D.O.",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Raymore, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.