Individual provider Active NPI

Kenneth Lan, MD

  • Internal Medicine Physician
  • Kansas City, MO
National Provider Identifier
1316439169
Registry record updated Sep 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2021031340 Issued in MO
Practice address
2330 E Meyer Blvd Ste 101
Kansas City, MO 64132-1140
Phone
(816) 276-9800
NPI assigned
Jun 6, 2018
Last updated
Sep 1, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2021031340 MO Primary

Addresses

Primary practice location

2330 E Meyer Blvd Ste 101
Kansas City, MO 64132-1140

Mailing address

2330 E Meyer Blvd Ste 101
Kansas City, MO 64132-1140
Phone (816) 276-9800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2018
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

6101 Blue Lagoon Dr
Suite 200
Miami, FL 33126

6101 Blue Lagoon Dr
Suite 200
Miami, FL 33126-3168

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2021031340MOMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Centerwell Senior Primary Care KS PA Internal Medicine CurrentSince Dec 8, 2024 Accepting new patients
Centerwell Senior Primary Care KS PA Internal Medicine CurrentSince Dec 8, 2024 Accepting new patients

Locations

6101 Waterford District Dr
Ste 200
Miami, FL 33126
Phone (407) 533-6836

16575 W 119th St
Olathe, KS 66061
Phone (913) 815-5008

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1528243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661990400000",
    "number": "1316439169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2330 E MEYER BLVD STE 101",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641321140",
            "telephone_number": "816-276-9800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2330 E MEYER BLVD STE 101",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641321140",
            "telephone_number": "816-276-9800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAN",
        "first_name": "KENNETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-06",
        "last_updated": "2022-09-01",
        "certification_date": "2022-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2021031340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.