Organization Active NPI

Wellspring Regenerative Health, LLC

  • Family Nurse Practitioner
  • Leawood, KS
National Provider Identifier
1407681687
Registry record updated Aug 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
WELLSPRING REGENERATIVE HEALTH, LLC
Practice address
13160 State Line Rd
Leawood, KS 66209-1708
Phone
(913) 270-9960
Fax
(913) 400-2091
NPI assigned
Sep 5, 2024
Last updated
Aug 28, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2026

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

Authorized official

Name
Mr. Anthony Breen, FNPNPI 1407567068
Title
Nurse Practitioner
Phone
(913) 270-9960

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

13160 State Line Rd
Leawood, KS 66209-1708

Mailing address

13160 State Line Rd
Leawood, KS 66209-1708
Phone (913) 270-9960

Other practice location 1

1741 NW Burdett Xing
Blue Springs, MO 64015-1610
Phone (913) 270-9960

Other identifiers 2

IdentifierTypeStateIssuer
1407567068MedicaidMO
1851823694MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS, MO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20250619002353 KS Part B Supplier - Clinic/Group Practice 5496266082 Receives reassigned benefits from 3 practitioners
Practice locations: Leawood, KS
O20260414003000 MO Part B Supplier - Clinic/Group Practice 5496266082 Receives reassigned benefits from 2 practitioners
Practice locations: Blue Springs, MO

National Provider Directory

National Provider Directory

Locations

13160 State Line Rd
Leawood, KS 66209
Phone (816) 651-7813

905 E Wea St
Paola, KS 66071
Phone (913) 952-3760

1741 NW Burdett Xing
Blue Springs, MO 64015
Phone (816) 427-5244

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1725494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787875200000",
    "number": "1407681687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13160 STATE LINE RD",
            "city": "LEAWOOD",
            "state": "KS",
            "postal_code": "662091708",
            "telephone_number": "913-270-9960",
            "fax_number": "913-400-2091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13160 STATE LINE RD",
            "city": "LEAWOOD",
            "state": "KS",
            "postal_code": "662091708",
            "telephone_number": "913-270-9960",
            "fax_number": "913-400-2091"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1741 NW Burdett Xing",
            "address_purpose": "LOCATION",
            "city": "Blue Springs",
            "state": "MO",
            "postal_code": "640151610",
            "country_code": "US",
            "telephone_number": "913-270-9960",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WELLSPRING REGENERATIVE HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-05",
        "last_updated": "2026-08-28",
        "certification_date": "2026-08-28",
        "status": "A",
        "authorized_official_last_name": "BREEN",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "913-270-9960",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1407567068",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1851823694",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leawood, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.