Individual provider Active NPI

Kellie A Wark, MD

  • Infectious Disease Physician
  • Kansas City, KS
National Provider Identifier
1619264199
Registry record updated Jan 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
04-40400 Issued in KS
Practice address
3901 Rainbow Blvd
6067 Delp, Mail Stop 1028
Kansas City, KS 66160
Phone
(913) 588-6035
Fax
(913) 945-6916
NPI assigned
Jul 5, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2018

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 9407723 KS
Infectious Disease Physician 207RI0200X 9407723 KS
Infectious Disease Physician 207RI0200X MD60652501 WA
Infectious Disease Physician 207RI0200X 04-40400 KS Primary

Addresses

Primary practice location

3901 Rainbow Blvd
6067 Delp, Mail Stop 1028
Kansas City, KS 66160

Mailing address

3901 Rainbow Blvd
6067 Delp, Mail Stop 1028
Kansas City, KS 66160
Phone (913) 588-3891

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171213001298 KS Practitioner - Infectious DiseasePractitioner - Internal Medicine 0143525006 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious DiseaseAlso: Internal Medicine
Education
University of Kansas School of Med (KC/Wich/Sal), 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kansas University Physicians IncGroup PAC ID 8921911587, 1,809 clinicians

Practice addresses (Care Compare)

3901 Rainbow Blvd
Kansas City, KS 66160-7415
Phone (913) 588-3315

Hospital & facility affiliations

  • University of Kansas Hospital Hospital, Kansas City, KS, CCN 170040
  • University of Kansas Health System Olathe Hospital Hospital, Olathe, KS, CCN 170049

Merit-based Incentive Payment System (MIPS)

Final score
92.91 of 100Reported as apm
Quality
77.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9407723KSMDInfectious Disease Physician
MD60652501WAMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kansas University Physicians Inc CurrentSince Nov 14, 2017 Accepting new patients
Kansas University Physicians Inc Internal Medicine Current Accepting new patients
Kansas University Physicians Inc Internal Medicine CurrentSince Nov 14, 2017 Accepting new patients

Locations

4000 Cambridge St
Kansas City, KS 66160
Phone (913) 588-0000

3901 Rainbow Blvd
Kansas City, KS 66160
Phone (913) 588-6005

3901 Rainbow Blvd
Stop 1028
Kansas City, KS 66160
Phone (913) 588-3891

Interoperability endpoints

  • Direct secure messaging: kwark12182@direct.kuha.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1309824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516320000000",
    "number": "1619264199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 RAINBOW BLVD",
            "address_2": "6067 DELP, MAIL STOP 1028",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "66160",
            "telephone_number": "913-588-3891",
            "fax_number": "913-945-6916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 RAINBOW BLVD",
            "address_2": "6067 DELP, MAIL STOP 1028",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "66160",
            "telephone_number": "913-588-6035",
            "fax_number": "913-945-6916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARK",
        "first_name": "KELLIE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-05",
        "last_updated": "2018-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KS",
            "license": "9407723",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "KS",
            "license": "9407723",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "WA",
            "license": "MD60652501",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "KS",
            "license": "04-40400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, KS

Sources for this page

Verify at the official NPI Registry.