Adam Fellows, PSY.D

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

2007029990 Issued in MO

Practice address

400 SW Longview Blvd Ste 160
Lees Summit, MO 64081-2112

Phone

(816) 761-3944

Fax

(866) 335-7993

NPI assigned

May 17, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

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 1

Specialty

Clinical Psychologist

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Rejuvenate, IncGroup PAC ID 0244395762, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Rejuvenate Inc

  • Clinical Psychologist
  • Lees Summit, MO
  • NPI 1669617841
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363824000000",
    "number": "1285686089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 SW LONGVIEW BLVD STE 160",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640812112",
            "telephone_number": "816-761-3944",
            "fax_number": "866-335-7993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 SW LONGVIEW BLVD STE 160",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640812112",
            "telephone_number": "816-761-3944",
            "fax_number": "866-335-7993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FELLOWS",
        "first_name": "ADAM",
        "name_prefix": "Dr.",
        "credential": "PSY.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2013-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MO",
            "license": "2007029990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason Faulkner, LMT
• Bruce E Fearon, M.D.
• Aeriel Feeback
• Felix N Sabates Jr MD Eye Care Center
• Elizabeth Fellhauer
• David Eugene Fellows, PA-C
• Tiffany Fellows, PSY.D.
• Jessica Renee Felton, MS, CCC-SLP
• Roger L Fender, DDS
• Timothy J Fendler, MD

• Clinical Psychologist in Lees Summit, MO
• Providers in Lees Summit, MO by specialty
• Clinical Psychologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2013; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.