NPIMap

Organization Active NPI

Pediatric Professionals

  • Pediatrics Physician
  • Lee's Summit, MO
National Provider Identifier
1710930490
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
PEDIATRIC PROFESSIONALS
Practice address
258 NE Tudor Rd
Lees Summit, MO 64086-5696
Phone
(816) 347-0303
Fax
(816) 347-0160
NPI assigned
May 17, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Teresa M BradyNPI 1205815933
Title
Owner/Physician
Phone
(816) 347-0303

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X NU Primary

Addresses

Primary practice location

258 NE Tudor Rd
Lees Summit, MO 64086-5696

Mailing address

258 NE Tudor Rd
Lees Summit, MO 64086-5696
Phone (816) 347-0303

National Provider Directory

National Provider Directory

Locations

258 NE Tudor Rd
Lees Summit, MO 64086
Phone (816) 347-0303

310 NE Tudor Rd
Lees Summit, MO 64086
Phone (816) 347-0303

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1710930490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "258 NE TUDOR RD",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640865696",
            "telephone_number": "816-347-0303",
            "fax_number": "816-347-0160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "258 NE TUDOR RD",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640865696",
            "telephone_number": "816-347-0303",
            "fax_number": "816-347-0160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC PROFESSIONALS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BRADY",
        "authorized_official_first_name": "TERESA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "816-347-0303",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lee's Summit, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.