Individual provider Active NPI

Robert Eugene Patterson Jr., D.C.

  • Chiropractor
  • Overland Park, KS
National Provider Identifier
1740336627
Registry record updated Feb 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
01-3883 Issued in KS
Practice address
11791 W 112TH St
Suite 101
Overland Park, KS 66210-2761
Phone
(913) 345-9247
NPI assigned
Jan 25, 2007
Last updated
Feb 10, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 01-3883 KS Primary

Addresses

Primary practice location

11791 W 112TH St
Suite 101
Overland Park, KS 66210-2761

Mailing address

9501 W 115TH Ter
Overland Park, KS 66210-2912
Phone (913) 322-3930

Other identifiers 4

IdentifierTypeStateIssuer
44-08041OtherKSUHC
13804025OtherMOBCBS KC
0000855017OtherKSAETNA
560461OtherKSBCBS KANSAS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050817001086 KS Practitioner - Chiropractic 8921038449 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Cleveland Chiropractic College - Kansas City, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

11791 W 112TH St
Suite 101
Overland Park, KS 66210-2755
Phone (913) 345-9247

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
01-3883KSMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Overland Chiropractic Health Services PA Chiropractor CurrentSince Jan 25, 1988 Accepting new patients
Arthur Chiropractic, LLC Chiropractor Past Accepting new patients

Locations

11705 College Blvd
Overland Park, KS 66210
Phone (913) 322-6326

11791 W 112th St
Ste 101
Overland Park, KS 66210
Phone (913) 345-9247

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581292800000",
    "number": "1740336627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9501 W 115TH TER",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662102912",
            "telephone_number": "913-322-3930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11791 W 112TH ST",
            "address_2": "SUITE 101",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662102761",
            "telephone_number": "913-345-9247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTERSON",
        "first_name": "ROBERT",
        "middle_name": "EUGENE",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-25",
        "last_updated": "2020-02-10",
        "certification_date": "2020-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KS",
            "license": "01-3883",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "44-08041",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS KC",
            "identifier": "13804025",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0000855017",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS KANSAS",
            "identifier": "560461",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2020; 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.