Individual provider Active NPI

Justin Halberstadt, MSN, MBA, FNP-C

  • Family Nurse Practitioner
  • Kansas City, MO
National Provider Identifier
1730626391
Registry record updated Sep 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2017000785 Issued in MO
Practice address
2401 Gillham Rd
Kansas City, MO 64108-4619
Phone
(816) 234-3000
Fax
(816) 302-9939
NPI assigned
Jan 20, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2017000785 MO Primary
Family Nurse Practitioner 363LF0000X 53-80652-041 KS

Addresses

Primary practice location

2401 Gillham Rd
Kansas City, MO 64108-4619

Mailing address

2401 Gillham Rd
Provider Enrollment Department
Kansas City, MO 64108-4619
Phone (816) 701-5200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, KS2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170217000323 MO Practitioner - Nurse Practitioner 4688957657 Reassigns benefits to 3 organizations
I20211210000343 KS Practitioner - Nurse Practitioner 4688957657 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Business Administration, Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
53-80652-041KSMDFamily Nurse Practitioner
2017000785MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kansas University Physicians Inc Current Accepting new patients
Minuteclinic Diagnostic of Kansas PA Family CurrentSince Feb 6, 2017 Accepting new patients
The Children'S Mercy Hospital CurrentSince Aug 27, 2025 Accepting new patients
The Children'S Mercy Hospital CurrentSince Aug 27, 2025 Accepting new patients
The Children'S Mercy Hospital Past Accepting new patients

Locations

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

11300 Corporate Ave
Ste 342
Lenexa, KS 66219
Phone (913) 574-0425

5808 W 110th St
Overland Park, KS 66211
Phone (913) 696-8000

3825 S Noland Rd
Independence, MO 64055
Phone (816) 254-6002

5440 NW 64th St
Kansas City, MO 64151
Phone (816) 506-9933

2401 Gillham Rd
Kansas City, MO 64108
Phone (816) 234-3380

2790 Clay Edwards Dr
Ste 405
North Kansas City, MO 64116
Phone (913) 588-3117

8021 Watson Rd
Webster Groves, MO 63119
Phone (314) 963-0398

Organizations & group practices 5

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": "1484870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757980800000",
    "number": "1730626391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 GILLHAM RD",
            "address_2": "PROVIDER ENROLLMENT DEPARTMENT",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641084619",
            "telephone_number": "816-701-5200",
            "fax_number": "816-302-9939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 GILLHAM RD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641084619",
            "telephone_number": "816-234-3000",
            "fax_number": "816-302-9939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALBERSTADT",
        "first_name": "JUSTIN",
        "credential": "MSN, MBA, FNP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-01-20",
        "last_updated": "2025-09-16",
        "certification_date": "2025-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2017000785",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "53-80652-041",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.