Active NPI
Bradley W Storm, MD
- Plastic and Reconstructive Surgery Physician
- Olathe, KS
National Provider Identifier
1457332454
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic and Reconstructive Surgery Physician
- License
- 0423438
- Practice address
- 20375 W 151St St #370
Premier Plastic Surgery
Olathe, KS 66061 - Phone
- (913) 782-0707
- Fax
- (913) 782-5813
- NPI assigned
- Nov 8, 2005
- Reactivated
- Nov 17, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery of the Hand (Surgery) Physician | 2086S0105X | 0423438 | KS | |
| Plastic and Reconstructive Surgery Physician | 2086S0122X | 0423438 | KS | Primary |
Addresses
Primary practice location
20375 W 151St St #370
Premier Plastic Surgery
Olathe, KS 66061
Mailing address
20375 W 151St St
Suite 370
Olathe, KS 66061
Phone (913) 782-0707
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1308048 | Other | KS | UNITED HEALTH CARE |
| 16274034 | Other | KS | BLUE CROSS |
| 10012005A | Medicaid | KS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0423438 | KS | MD | Plastic and Reconstructive Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131408000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1312329600000",
"number": "1457332454",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20375 W 151ST ST",
"address_2": "SUITE 370",
"city": "OLATHE",
"state": "KS",
"postal_code": "66061",
"telephone_number": "913-782-0707",
"fax_number": "913-782-5813"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20375 W 151ST ST #370",
"address_2": "PREMIER PLASTIC SURGERY",
"city": "OLATHE",
"state": "KS",
"postal_code": "66061",
"telephone_number": "913-782-0707",
"fax_number": "913-782-5813"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STORM",
"first_name": "BRADLEY",
"middle_name": "W",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-08",
"last_updated": "2011-08-03",
"deactivation_date": "2005-11-08",
"reactivation_date": "2006-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0105X",
"taxonomy_group": "",
"desc": "Surgery, Surgery of the Hand",
"state": "KS",
"license": "0423438",
"primary": false
},
{
"code": "2086S0122X",
"taxonomy_group": "",
"desc": "Surgery, Plastic and Reconstructive Surgery",
"state": "KS",
"license": "0423438",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTH CARE",
"identifier": "1308048",
"state": "KS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "16274034",
"state": "KS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "10012005A",
"state": "KS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Olathe, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.