Radiance Health & Wellness Clinic Mo-KS

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

RADIANCE HEALTH & WELLNESS CLINIC MO-KS

Doing business as

Radiance Health & Wellness

Practice address

6225 Raytown Trfy
Raytown, MO 64133-3846

Phone

(816) 510-4549

NPI assigned

Sep 11, 2023

Last updated

Jul 29, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Amie Fabah, DNPNPI 1336512474

Title

Dr Ezeogu

Phone

(816) 510-4549

Specialties & licenses 1

Addresses

Other names 1

• Radiance Health & Wellness Doing business as

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Amie Fabah

  • Psychiatric/Mental Health Nurse Practitioner
  • Raytown, MO
  • NPI 1336512474
  Authorized official Same address or phone
• Sudha T Chaudhuri, MD

  • Obstetrics & Gynecology Physician
  • Kansas City, MO
  • NPI 1316951379
  NPD (past)
• Jason Thomas Miller, MSW, LCSW

  • Mental Health Counselor
  • Independence, MO
  • NPI 1144398322
  NPD (past)

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

{
    "created_epoch": "1694390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753747200000",
    "number": "1407633902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12641 ANTIOCH RD # 1053",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662131701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6225 RAYTOWN TRFY",
            "city": "RAYTOWN",
            "state": "MO",
            "postal_code": "641333846",
            "telephone_number": "816-510-4549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADIANCE HEALTH & WELLNESS CLINIC MO-KS",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-11",
        "last_updated": "2025-07-29",
        "certification_date": "2025-07-29",
        "status": "A",
        "authorized_official_last_name": "FABAH",
        "authorized_official_first_name": "AMIE",
        "authorized_official_title_or_position": "DR EZEOGU",
        "authorized_official_telephone_number": "816-510-4549",
        "authorized_official_credential": "DNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Radiance Health & Wellness",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Radiance Health & Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sydney Lisa Renee Pulliam, PT, DPT
• Quince's Health Care, LLC
• R & R Express Medical Services L.L.C.
• R K Matthews Investments Inc. (Alpha & Omega 3 Private Home Health Care)
• R.D.B. Enterprises LLC
• Jennifer Ramaeker, MS, CCC-SLP
• Melanie Alexis Ramos-Green, MA
• Raytown Dental (Comfort Dental Raytown)
• Raytown Dental LLC (Comfort Dental Raytown)
• Raytown Dental PLLC

• Psychiatric/Mental Health Nurse Practitioner in Raytown, MO
• Providers in Raytown, MO by specialty
• Psychiatric/Mental Health Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2025; 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.