Individual provider Active NPI

Bruce Gehrke, M.D.

  • Surgery Physician
  • Kansas City, MO
National Provider Identifier
1619065299
Registry record updated Nov 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
R3H19 Issued in MO
Practice address
5844 NW Barry Rd Ste 120
Kansas City, MO 64154-1483
Phone
(816) 472-9595
Fax
(816) 472-1132
NPI assigned
Oct 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X R3H19 MO Primary
Surgery Physician 208600000X 04-35928 KS

Addresses

Primary practice location

5844 NW Barry Rd Ste 120
Kansas City, MO 64154-1483

Mailing address

901 E 104TH St
Mailstop 400
Kansas City, MO 64131
Phone (816) 502-8755

Other practice location 1

2750 Clay Edwards Dr
Suite 404
North Kansas City, MO 64116-3258
Phone (816) 472-9595

Other identifiers 1

IdentifierTypeStateIssuer
202487310MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
04-35928KSMDSurgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511136000000",
    "number": "1619065299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 E 104TH ST",
            "address_2": "MAILSTOP 400",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "64131",
            "telephone_number": "816-502-8755",
            "fax_number": "816-932-9670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5844 NW BARRY RD STE 120",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641541483",
            "telephone_number": "816-472-9595",
            "fax_number": "816-472-1132"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2750 Clay Edwards Dr",
            "address_2": "Suite 404",
            "address_purpose": "LOCATION",
            "city": "North Kansas City",
            "state": "MO",
            "postal_code": "641163258",
            "country_code": "US",
            "telephone_number": "816-472-9595",
            "fax_number": "816-472-0038",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GEHRKE",
        "first_name": "BRUCE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2017-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MO",
            "license": "R3H19",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "KS",
            "license": "04-35928",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "202487310",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2017; 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.