NPIMap

Individual provider Active NPI

Ian Richard Tally, D.O.

  • Hospitalist Physician
  • North Kansas City, MO
National Provider Identifier
1386008019
Registry record updated Jun 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
2018036868 Issued in MO
Practice address
2700 Clay Edwards Dr Ste 240
North Kansas City, MO 64116-3254
Phone
(816) 455-0681
Fax
(816) 455-5294
NPI assigned
Apr 8, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 2018036868 MO Primary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 2018036868 MO

Addresses

Primary practice location

2700 Clay Edwards Dr Ste 240
North Kansas City, MO 64116-3254

Mailing address

2700 Clay Edwards Dr Ste 240
North Kansas City, MO 64116-3254
Phone (816) 691-5287

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190718003267 MO Practitioner - HospitalistPractitioner - Internal Medicine 5991030587 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Meritas Health CorporationGroup PAC ID 6305748153, 492 clinicians

Practice addresses (Care Compare)

2700 Clay Edwards Dr
Suite 240
North Kansas City, MO 64116-3254
Phone (816) 455-0681

Hospital & facility affiliations

  • NKC Health Hospital, North Kansas City, MO, CCN 260096

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2018036868MOMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Meritas Health Corporation Current Accepting new patients
Meritas Health Corporation Internal Medicine CurrentSince Sep 1, 2019 Accepting new patients
Meritas Health Corporation CurrentSince Sep 1, 2019 Accepting new patients
North Kansas City Hospital Past Accepting new patients
Meritas Health Corporation Past Accepting new patients
Meritas Health Corporation Past Accepting new patients

Locations

2700 Clay Edwards Dr
Ste 240
North Kansas City, MO 64116
Phone (816) 455-0681

Organizations & group practices 6

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1460073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560729600000",
    "number": "1386008019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 CLAY EDWARDS DR STE 240",
            "city": "NORTH KANSAS CITY",
            "state": "MO",
            "postal_code": "641163254",
            "telephone_number": "816-691-5287",
            "fax_number": "816-346-7690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 CLAY EDWARDS DR STE 240",
            "city": "NORTH KANSAS CITY",
            "state": "MO",
            "postal_code": "641163254",
            "telephone_number": "816-455-0681",
            "fax_number": "816-455-5294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TALLY",
        "first_name": "IAN",
        "middle_name": "RICHARD",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-08",
        "last_updated": "2019-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MO",
            "license": "2018036868",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2018036868",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Kansas City, MO

Sources for this page

Verify at the official NPI Registry.