Individual provider Active NPI

Raymond W Obrien, PHD

  • Psychologist
  • Kansas City, MO
National Provider Identifier
1639188451
Registry record updated Mar 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PY01239 Issued in MO
Practice address
6405 N Cosby Ave
Ste 203
Kansas City, MO 64151-2378
Phone
(816) 746-4743
Fax
(816) 746-4753
NPI assigned
Aug 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PY01239 MO Primary

Addresses

Primary practice location

6405 N Cosby Ave
Ste 203
Kansas City, MO 64151-2378

Mailing address

6405 N Cosby Ave
Ste 203
Kansas City, MO 64151-2378
Phone (816) 746-4743

Other identifiers 1

IdentifierTypeStateIssuer
498474618MedicaidMO

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 Philosophy

State licenses

LicenseStateTypeSpecialty
PY01239MOMDPsychologist
01239MOMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Sandra Loughlin, PH.D., P.C. Psychologist CurrentSince Apr 1, 2007 Accepting new patients

Locations

6405 N Cosby Ave
Ste 203
Kansas City, MO 64151
Phone (816) 391-9008

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332806400000",
    "number": "1639188451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6405 N COSBY AVE",
            "address_2": "STE 203",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641512378",
            "telephone_number": "816-746-4743",
            "fax_number": "816-746-4753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6405 N COSBY AVE",
            "address_2": "STE 203",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641512378",
            "telephone_number": "816-746-4743",
            "fax_number": "816-746-4753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBRIEN",
        "first_name": "RAYMOND",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2012-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MO",
            "license": "PY01239",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "498474618",
            "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 Mar 27, 2012; 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.