Organization Active NPI

Blue Lotus Family Medicine, LLC

  • Family Medicine Physician
  • Lees Summit, MO
National Provider Identifier
1538711445
Registry record updated Jul 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
BLUE LOTUS FAMILY MEDICINE, LLC
Practice address
4963 NE Goodview Cir Ste B
Lees Summit, MO 64064-2491
Phone
(816) 656-2316
Fax
(816) 281-1985
NPI assigned
Jul 10, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2019

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

Authorized official

Name
Tiffanny Pitts Blythe, DO
Title
Owner/Physician
Phone
(816) 656-2316

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

4963 NE Goodview Cir Ste B
Lees Summit, MO 64064-2491

Mailing address

4963 NE Goodview Cir Ste B
Lees Summit, MO 64064-2491
Phone (816) 656-2316

National Provider Directory

National Provider Directory

Locations

4963 NE Goodview Cir
Ste B
Lees Summit, MO 64064
Phone (816) 795-7100

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1562716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562716800000",
    "number": "1538711445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4963 NE GOODVIEW CIR STE B",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640642491",
            "telephone_number": "816-656-2316",
            "fax_number": "816-281-1985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4963 NE GOODVIEW CIR STE B",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640642491",
            "telephone_number": "816-656-2316",
            "fax_number": "816-281-1985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE LOTUS FAMILY MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-10",
        "last_updated": "2019-07-10",
        "status": "A",
        "authorized_official_last_name": "BLYTHE",
        "authorized_official_first_name": "TIFFANNY",
        "authorized_official_middle_name": "PITTS",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "816-656-2316",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lees Summit, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.