Individual provider Active NPI

Michael B Lubbers, PHD

  • Psychologist
  • Kansas City, MO
National Provider Identifier
1366518375
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
MOPY1237 Issued in MO
Practice address
8301 State Line Road
Suite 200
Kansas City, MO 64114-2019
Phone
(816) 363-5600
Fax
(816) 363-5159
NPI assigned
Nov 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X MOPY1237 MO Primary
Psychologist 103T00000X 658 KS

Addresses

Primary practice location

8301 State Line Road
Suite 200
Kansas City, MO 64114-2019

Mailing address

8301 State Line Road
Suite 200
Kansas City, MO 64114-2019
Phone (816) 363-5600

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20110223001227 MO Practitioner - Clinical Psychologist 3476734468 Practice locations: Kansas City, MO

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

8301 State Line Rd
Kansas City, MO 64114-2019
Phone (816) 363-5600

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
658KSMDPsychologist
MOPY1237MOMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366518375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8301 STATE LINE ROAD",
            "address_2": "SUITE 200",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641142019",
            "telephone_number": "816-363-5600",
            "fax_number": "816-363-5159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8301 STATE LINE ROAD",
            "address_2": "SUITE 200",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641142019",
            "telephone_number": "816-363-5600",
            "fax_number": "816-363-5159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUBBERS",
        "first_name": "MICHAEL",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MO",
            "license": "MOPY1237",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "KS",
            "license": "658",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.