NPIMap

Individual provider Active NPI

Regina M. Aholt, M.D.

  • Family Medicine Physician
  • Lee's Summit, MO
National Provider Identifier
1508899691
Registry record updated Jun 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2004023903 Issued in MO
Practice address
20 NE Saint Lukes Blvd
Suite 200
Lees Summit, MO 64086-6003
Phone
(816) 347-5100
Fax
(816) 347-5136
NPI assigned
Jul 9, 2006
Last updated
Jun 4, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2004023903 MO Primary

Addresses

Primary practice location

20 NE Saint Lukes Blvd
Suite 200
Lees Summit, MO 64086-6003

Mailing address

20 NE Saint Lukes Blvd Ste 200
Lees Summit, MO 64086-6001
Phone (816) 347-5100

Other identifiers 1

IdentifierTypeStateIssuer
207308701MedicaidMO

Other names 1

  • Regina M. Cooley Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050324000651 MO Practitioner - Family Practice 3971559774 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Missouri, Kansas City, School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Saint Lukes Physician Group IncGroup PAC ID 3577476894, 1,233 clinicians

Practice addresses (Care Compare)

20 NE Saint Lukes Blvd
Lee's Summit, MO 64086-6001

601 S 169 Hwy
Smithville, MO 64089-9317
Phone (816) 532-3700

601 S US Hwy 169
Smithville, MO 64089-9317
Phone (816) 532-3999

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2004023903MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Luke's Physician Group Inc Family Medicine CurrentSince Mar 1, 2017 Accepting new patients

Locations

901 E 104th St
#400N
Kansas City, MO 64131
Phone (816) 502-8756

20 NE Saint Lukes Blvd
Ste 200
Lees Summit, MO 64086
Phone (816) 347-5100

601 S US Highway 169
Smithville, MO 64089
Phone (816) 532-3999

Interoperability endpoints

  • Direct secure messaging: raholt4091@direct.saint-lukes.org

Organizations & group practices 1

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559606400000",
    "number": "1508899691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 NE SAINT LUKES BLVD STE 200",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640866001",
            "telephone_number": "816-347-5100",
            "fax_number": "816-347-5136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 NE SAINT LUKES BLVD",
            "address_2": "SUITE 200",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640866003",
            "telephone_number": "816-347-5100",
            "fax_number": "816-347-5136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHOLT",
        "first_name": "REGINA",
        "middle_name": "M.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-09",
        "last_updated": "2019-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2004023903",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207308701",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REGINA",
            "last_name": "COOLEY",
            "middle_name": "M.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lee's Summit, MO

Sources for this page

Verify at the official NPI Registry.