NPIMap

Individual provider Active NPI

Kimberlie D Wells, DO

  • Psychiatry Physician
  • Lee's Summit, MO
National Provider Identifier
1386104750
Registry record updated Oct 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
2023010356 Issued in MO
Practice address
100 NE Saint Lukes Blvd
Lees Summit, MO 64086-6000
Phone
(816) 932-1711
NPI assigned
Mar 22, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 0548023 KS
Psychiatry Physician 2084P0800X 2023010356 MO Primary

Addresses

Primary practice location

100 NE Saint Lukes Blvd
Lees Summit, MO 64086-6000

Mailing address

901 E 104TH St
Mailstop 400S
Kansas City, MO 64131
Phone (816) 932-1711

Other names 1

  • Kimberlie Dawn Koechner Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, KS2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230818003172 MO Practitioner - Psychiatry 8325371271 Reassigns benefits to 1 organization
I20230905000344 KS Practitioner - Psychiatry 8325371271 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Saint Lukes Physician Group IncGroup PAC ID 3577476894, 1,233 clinicians

Practice addresses (Care Compare)

12300 Metcalf Ave
Overland Park, KS 66213-1324
Phone (913) 317-7000

4400 Broadway Blvd
Suite 300
Kansas City, MO 64111-3342
Phone (816) 932-1711

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.56 of 100Reported as group
Quality
76.07
Promoting interoperability
100
Improvement activities
40
Cost
65.79

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0548023KSMDPsychiatry Physician
2023010356MOMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Luke's Physician Group Inc CurrentSince Aug 21, 2023 Accepting new patients

Locations

711 Marshall St
Leavenworth, KS 66048
Phone (913) 684-1100

12330 Metcalf Ave
Ste 500A
Overland Park, KS 66213
Phone (913) 323-9000

12300 Metcalf Ave
Shawnee Mission, KS 66213
Phone (913) 317-7000

901 E 104th St
#400S
Kansas City, MO 64131
Phone (816) 502-7117

5844 NW Barry Rd
Ste 110
Kansas City, MO 64154
Phone (816) 880-6100

4400 Broadway Blvd
Ste 300
Kansas City, MO 64111

100 NE Saint Lukes Blvd
Lees Summit, MO 64086
Phone (816) 347-5097

601 S US Highway 169
Smithville, MO 64089
Phone (816) 532-3999

Interoperability endpoints

  • Direct secure messaging: kwells628323@direct.saint-lukes.org

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1553212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697155200000",
    "number": "1386104750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 E 104TH ST",
            "address_2": "MAILSTOP 400S",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "64131",
            "telephone_number": "816-932-1711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 NE SAINT LUKES BLVD",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640866000",
            "telephone_number": "816-932-1711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLS",
        "first_name": "KIMBERLIE",
        "middle_name": "D",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-22",
        "last_updated": "2023-10-13",
        "certification_date": "2023-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "KS",
            "license": "0548023",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MO",
            "license": "2023010356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLIE",
            "last_name": "KOECHNER",
            "middle_name": "DAWN",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lee's Summit, MO

Sources for this page

Verify at the official NPI Registry.