Individual provider Active NPI

Robert Claude Kamtio Kamgoum, NP

  • Gerontology Nurse Practitioner
  • Kansas City, MO
National Provider Identifier
1457839573
Registry record updated Dec 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
53-78146-01 Issued in KS
Practice address
406 W 34TH St Ste 428
Kansas City, MO 64111-3113
Phone
(913) 709-2712
NPI assigned
Jul 31, 2018
Last updated
Dec 2, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 53-78146-01 KS Primary

Addresses

Primary practice location

406 W 34TH St Ste 428
Kansas City, MO 64111-3113

Mailing address

732 S Maple St
Gardner, KS 66030
Phone (913) 244-7319

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS, NM2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180918001832 KS Practitioner - Nurse Practitioner 5496004707 Reassigns benefits to 3 organizations
I20260413002976 NM Practitioner - Nurse Practitioner 5496004707 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mokscare Family MedicineGroup PAC ID 2961871108, 12 clinicians

Practice addresses (Care Compare)

7721 Quivira Rd
Lenexa, KS 66216-3401
Phone (913) 706-2508

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
53-78146-01KSMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Truhealth, LLC CurrentSince Jan 27, 2020 Accepting new patients
KC Geriatrics LLC CurrentSince Dec 6, 2020 Accepting new patients
Mokscare Family Medicine CurrentSince Oct 2, 2024 Accepting new patients

Locations

757 W Eisenhower Rd
Lansing, KS 66043
Phone (913) 534-8336

7721 Quivira Rd
Shawnee, KS 66216
Phone (913) 248-2838

1438 Girard Blvd NE
Albuquerque, NM 87106
Phone (505) 308-8150

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1532995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575244800000",
    "number": "1457839573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "732 S MAPLE ST",
            "city": "GARDNER",
            "state": "KS",
            "postal_code": "66030",
            "telephone_number": "913-244-7319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 W 34TH ST STE 428",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641113113",
            "telephone_number": "913-709-2712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAMTIO KAMGOUM",
        "first_name": "ROBERT",
        "middle_name": "CLAUDE",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-07-31",
        "last_updated": "2019-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "KS",
            "license": "53-78146-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.