Individual provider Active NPI

McKenzie Jean Samson, MD

  • Anesthesiology Physician
  • Kansas City, KS
National Provider Identifier
1487404299
Registry record updated Jul 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
94-12179 Issued in KS
Practice address
3901 Rainbow Blvd # Ms 1034
Kansas City, KS 66160-1902
Phone
(913) 588-3304
Fax
(913) 588-3365
NPI assigned
Mar 25, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 94-12179 KS Primary

Addresses

Primary practice location

3901 Rainbow Blvd # Ms 1034
Kansas City, KS 66160-1902

Mailing address

3901 Rainbow Blvd # Ms 1034
Kansas City, KS 66160-8500
Phone (913) 588-3304

Other practice location 1

2001 W 86th St
Indianapolis, IN 46260-1902
Phone (317) 338-6399

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240622000095 IN Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 6406399187

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
94-12179KSMDAnesthesiology Physician

NPI Registry JSON

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

{
    "created_epoch": "1711324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751328000000",
    "number": "1487404299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 RAINBOW BLVD # MS 1034",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661608500",
            "telephone_number": "913-588-3304",
            "fax_number": "913-588-3365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 RAINBOW BLVD # MS 1034",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661601902",
            "telephone_number": "913-588-3304",
            "fax_number": "913-588-3365"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2001 W 86th St",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462601902",
            "country_code": "US",
            "telephone_number": "317-338-6399",
            "fax_number": "317-338-6359",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAMSON",
        "first_name": "MCKENZIE",
        "middle_name": "JEAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-25",
        "last_updated": "2025-07-01",
        "certification_date": "2025-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "KS",
            "license": "94-12179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, KS

Sources for this page

Verify at the official NPI Registry.