Kcpedsrd LLC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

Legal business name

KCPEDSRD LLC

Practice address

2420 SW Winterfield CT
Lees Summit, MO 64081-4098

Phone

(816) 875-0077

NPI assigned

Aug 24, 2022

Organization subpart

No

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

Authorized official

Name

Mrs. Alexandra Mae Gregg, RD, LDNPI 1598498453

Title

Dietitian

Phone

(816) 875-0077

Specialties & licenses 1

Addresses

Practitioners 1

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

• Alexandra Mae Gregg, RD, LD

  • Registered Dietitian
  • Lees Summit, MO
  • NPI 1598498453
  NPD Authorized official

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

{
    "created_epoch": "1661299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667865600000",
    "number": "1548989502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8450 NW PRAIRIE VIEW RD # 1441",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641531841",
            "telephone_number": "816-875-0077",
            "fax_number": "507-322-1832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2420 SW WINTERFIELD CT",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640814098",
            "telephone_number": "816-875-0077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KCPEDSRD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-24",
        "last_updated": "2022-11-08",
        "certification_date": "2022-11-08",
        "status": "A",
        "authorized_official_last_name": "GREGG",
        "authorized_official_first_name": "ALEXANDRA",
        "authorized_official_middle_name": "MAE",
        "authorized_official_title_or_position": "DIETITIAN",
        "authorized_official_telephone_number": "816-875-0077",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RD, LD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Kcrcmd Inc
• Jason Edward Kearns, PA-C
• Katherine Anne Keaton, APRN
• Chandler Keeton
• Melissa Kehoe

• Medical Specialty Clinic/Center in Lees Summit, MO
• Providers in Lees Summit, MO by specialty
• Medical Specialty Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2022; 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.