Active NPI
Joel Maurice Feder, D.O.
- Family Medicine Physician
- Kansas City, MO
National Provider Identifier
1336103134
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- R7325
- Practice address
- 4601 Independence Ave
Kansas City, MO 64124 - Phone
- (816) 753-5144
- Fax
- (816) 753-0804
- NPI assigned
- Apr 17, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 05-16907 | KS | |
| Family Medicine Physician | 207Q00000X | R7325 | MO | Primary |
Addresses
Primary practice location
4601 Independence Ave
Kansas City, MO 64124
Mailing address
3515 Broadway Blvd
Kansas City, MO 64111-2501
Phone (816) 753-5144
Other practice location 1
6740 W 121st St
Overland Park, KS 66209-2002
Phone (913) 894-6500
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 57321013 | Other | MO | BCBS |
| 200031852 | Medicaid | MO |
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 |
|---|---|---|---|
| 05-16907 | KS | MD | Family Medicine Physician |
Interoperability endpoints
- joel.feder.1@19814.direct.athenahealth.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145232000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1541462400000",
"number": "1336103134",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3515 BROADWAY BLVD",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "641112501",
"telephone_number": "816-753-5144",
"fax_number": "816-753-0804"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4601 INDEPENDENCE AVE",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "64124",
"telephone_number": "816-753-5144",
"fax_number": "816-753-0804"
}
],
"practiceLocations": [
{
"address_1": "6740 W 121st St",
"address_purpose": "LOCATION",
"city": "Overland Park",
"state": "KS",
"postal_code": "662092002",
"country_code": "US",
"telephone_number": "913-894-6500",
"fax_number": "913-894-6001",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FEDER",
"first_name": "JOEL",
"middle_name": "MAURICE",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-17",
"last_updated": "2018-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "KS",
"license": "05-16907",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MO",
"license": "R7325",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "57321013",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200031852",
"state": "MO"
}
],
"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 Nov 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.