Active NPI
Haven Lackey
- Registered Dietitian
- Kansas City, MO
National Provider Identifier
1831068402
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 2025043883
- Practice address
- 4141 Dr Martin Luther King Jr Blvd
Kansas City, MO 64130-3212 - Phone
- (816) 321-3299
- NPI assigned
- Nov 3, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 2025043883 | MO | Primary |
| Registered Dietitian | 133V00000X | 3426 | KS |
Addresses
Primary practice location
4141 Dr Martin Luther King Jr Blvd
Kansas City, MO 64130-3212
Mailing address
4141 Dr Martin Luther King Jr Blvd
Kansas City, MO 64130-3212
Phone (816) 321-3299
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3426 | KS | MD | Registered Dietitian |
| 2025043883 | MO | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1762128000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1762128000000",
"number": "1831068402",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4141 DR MARTIN LUTHER KING JR BLVD",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "641303212",
"telephone_number": "816-321-3299"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4141 DR MARTIN LUTHER KING JR BLVD",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "641303212",
"telephone_number": "816-321-3299"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LACKEY",
"first_name": "HAVEN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-11-03",
"last_updated": "2025-11-03",
"certification_date": "2025-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MO",
"license": "2025043883",
"primary": true
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "KS",
"license": "3426",
"primary": false
}
],
"identifiers": [],
"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 Nov 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.