Individual provider Active NPI

Ann P Polenz, RD

  • Registered Dietitian
  • Kansas City, MO
National Provider Identifier
1699511733
Registry record updated Jul 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
2021046330 Issued in MO
Practice address
4330 Wornall Rd Ste 2000
Kansas City, MO 64111-5939
Phone
(816) 931-1883
NPI assigned
Jul 8, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 2021046330 MO Primary

Addresses

Primary practice location

4330 Wornall Rd Ste 2000
Kansas City, MO 64111-5939

Mailing address

901 E 104TH St
Mailstop 400S
Kansas City, MO 64131
Phone (816) 931-1883

Other names 1

  • Tricia Ludwig Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240719002669 MO Practitioner - Registered Dietitian Or Nutrition Professional 9537605019 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Saint Lukes Physician Group IncGroup PAC ID 3577476894, 1,233 clinicians

Practice addresses (Care Compare)

4330 Wornall Rd
Suite 2000
Kansas City, MO 64111-5939
Phone (816) 931-1883

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2021046330MOMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Luke'S Physician Group Inc CurrentSince Jul 1, 2024 Accepting new patients

Locations

5844 NW Barry Rd
Ste 110
Kansas City, MO 64154
Phone (816) 880-6100

4330 Wornall Rd
Ste 2000
Kansas City, MO 64111

901 E 104th St
#400S
Kansas City, MO 64131
Phone (816) 502-7117

601 S US Highway 169
Smithville, MO 64089
Phone (816) 532-3999

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": "1720396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720396800000",
    "number": "1699511733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 E 104TH ST",
            "address_2": "MAILSTOP 400S",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "64131",
            "telephone_number": "816-931-1883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4330 WORNALL RD STE 2000",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641115939",
            "telephone_number": "816-931-1883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLENZ",
        "first_name": "ANN",
        "middle_name": "P",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-08",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MO",
            "license": "2021046330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRICIA",
            "last_name": "LUDWIG",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Jul 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.