Carl E Ledbetter, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

R9971 Issued in MO

Practice address

1700 Rainbow Blvd
Excelsior Springs, MO 64024-1182

Phone

(816) 630-6081

Fax

(816) 629-3661

NPI assigned

Oct 5, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

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.

• Kearney Family Medicine

  • Clinic/Center
  • Kearney, MO
  • NPI 1912114539

  Family Medicine

  NPD (past) Authorized official

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

{
    "created_epoch": "1128470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421971200000",
    "number": "1346237120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 RAINBOW BLVD",
            "city": "EXCELSIOR SPRINGS",
            "state": "MO",
            "postal_code": "640241182",
            "telephone_number": "816-630-6081",
            "fax_number": "816-629-3661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 RAINBOW BLVD",
            "city": "EXCELSIOR SPRINGS",
            "state": "MO",
            "postal_code": "640241182",
            "telephone_number": "816-630-6081",
            "fax_number": "816-629-3661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEDBETTER",
        "first_name": "CARL",
        "middle_name": "E",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-05",
        "last_updated": "2015-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "R9971",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "241820745",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kirstyn Lanae Lafrenz, FNP
• James R Lasalle, DO
• Meredith Adair Leach, M.D.
• Leatherman Clinic, Inc.
• Amy Leavitt, RPH
• Life Recovery Consulting LLC
• Aram Lila, M.D.
• Vanessa Lincoln, RN
• Lives Without Limits
• Tiffany J Lumpkins, MA, CCC-SLP

• Family Medicine Physician in Excelsior Springs, MO
• Providers in Excelsior Springs, MO by specialty
• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.