NPIMap

Organization Active NPI

Liveactive Multispecialty Physician Group LLC

  • Internal Medicine Physician
  • Overland Park, KS
National Provider Identifier
1558093575
Registry record updated Jun 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
LIVEACTIVE MULTISPECIALTY PHYSICIAN GROUP LLC
Practice address
6650 W 110TH Street
Suite 220a
Overland Park, KS 66211
Phone
(913) 549-3884
Fax
(913) 273-3343
NPI assigned
Jun 28, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2022

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

Authorized official

Name
Haseeb Ahmed, DONPI 1972701571
Title
Owner
Phone
(913) 549-3884

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X

Addresses

Primary practice location

6650 W 110TH Street
Suite 220a
Overland Park, KS 66211

Mailing address

7111 W 151St St Ste 303
Overland Park, KS 66223-2231
Phone (913) 549-3884

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, KS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20230120000806 MO Part B Supplier - Clinic/Group Practice 9436520954 Receives reassigned benefits from 11 practitioners
Practice locations: Kansas City, MO
O20230130001657 KS Part B Supplier - Clinic/Group Practice 9436520954 Receives reassigned benefits from 9 practitioners
Practice locations: Overland Park, KS

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1656374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656374400000",
    "number": "1558093575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7111 W 151ST ST STE 303",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662232231",
            "telephone_number": "913-549-3884",
            "fax_number": "913-273-3343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6650 W 110TH STREET",
            "address_2": "SUITE 220A",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "66211",
            "telephone_number": "913-549-3884",
            "fax_number": "913-273-3343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVEACTIVE MULTISPECIALTY PHYSICIAN GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-28",
        "last_updated": "2022-06-28",
        "certification_date": "2022-05-27",
        "status": "A",
        "authorized_official_last_name": "AHMED",
        "authorized_official_first_name": "HASEEB",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "913-549-3884",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.