Individual provider Active NPI

Rafael Sampaio de Souza, DC

  • Chiropractor
  • Kansas City, MO
National Provider Identifier
1326754342
Registry record updated Jan 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2022043605 Issued in MO
Practice address
3611 Main St Ste 103
Kansas City, MO 64111-1932
Phone
(816) 561-7035
NPI assigned
Jan 24, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2022043605 MO Primary

Addresses

Primary practice location

3611 Main St Ste 103
Kansas City, MO 64111-1932

Mailing address

3611 Main St Ste 103
Kansas City, MO 64111-1932
Phone (816) 561-7035

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240831000376 MO Practitioner - Chiropractic 3577002732 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
FMH Health Solutions PCGroup PAC ID 7517118151, 2 clinicians

Practice addresses (Care Compare)

3611 Main St
Suite 103
Kansas City, MO 64111-1932
Phone (816) 561-7035

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2022043605MOMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
FMH Health Solutions PC Chiropractor CurrentSince Aug 21, 2024 Accepting new patients
Chiropractic Wellness Center PC Chiropractor PastSince Jan 29, 2023 Accepting new patients

Locations

3611 Main St
Ste 103
Kansas City, MO 64111
Phone (816) 561-7035

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1674518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674518400000",
    "number": "1326754342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3611 MAIN ST STE 103",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641111932",
            "telephone_number": "816-561-7035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3611 MAIN ST STE 103",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641111932",
            "telephone_number": "816-561-7035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMPAIO DE SOUZA",
        "first_name": "RAFAEL",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-01-24",
        "last_updated": "2023-01-24",
        "certification_date": "2023-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2022043605",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jan 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.