Active NPI
Johnson Underwood IV, MD
- Diagnostic Radiology Physician
- Kansas City, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 112408
- Practice address
- 2800 Clay Edwards Dr
Kansas City, MO 64116-3220 - Phone
- (816) 691-5201
- NPI assigned
- Jun 26, 2006
- Last updated
- Dec 7, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 112408 | MO | Primary |
Addresses
Primary practice location
2800 Clay Edwards Dr
Kansas City, MO 64116-3220
Mailing address
PO Box 419380 - Dept 128
Kansas City, MO 64141-6380
Phone (913) 642-4900
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 300074147 | Other | MO | RR MEDICARE |
| 1861429979 | Medicaid | MO | |
| 100299860A | Medicaid | KS | |
| 5087570 | Other | MO | AETNA |
| 24439012 | Other | MO | BCBSKC |
| 14730 | Other | MO | CMFHP |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Diagnostic Radiology
- Education
- University of Kansas School of Med (KC/Wich/Sal), 1992
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2800 Clay Edwards Dr
N Kansas City, MO 64116-3220
Phone (913) 642-4900
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 112408 | MO | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northland Radiology, Inc. | Diagnostic Radiology | Current | Accepting new patients |
| North Kansas City Hospital | Past | Accepting new patients |
Locations
5501 NW 62nd Ter
Ste 200
Kansas City, MO 64151
Phone (816) 691-1333
9501 N Oak Trfy
Kansas City, MO 64155
Phone (816) 255-6336
2800 Hospital Dr
North Kansas City, MO 64116
Phone (816) 221-5050
Interoperability endpoints
- https://fhir-myrecord.cerner.com/r4/MtxVU3dbzZwHcvfCb2vTAE2_Nwhai9Oq/
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.
-
- Diagnostic Radiology Physician
- Kansas City, MO
- NPI 1679518260
-
dba NKC Health
- Community/Retail Pharmacy
- North Kansas City, MO
- NPI 1003381948
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Excelsior Springs Hospital
- Critical Access Hospital
- Excelsior Springs, MO
- NPI 1609870310
-
dba Skilled Nursing Unit
- Skilled Nursing Facility
- North Kansas City, MO
- NPI 1437103215
Hospital
-
dba NKC Health
- General Acute Care Hospital
- North Kansas City, MO
- NPI 1629062799
-
- Critical Access Hospital
- Richmond, MO
- NPI 1245220052
-
dba University of Kansas Hospital / University of Kansas Cancer Center
- General Acute Care Hospital
- Kansas City, KS
- NPI 1629369681
-
dba The University of Kansas Hospital
- General Acute Care Hospital
- Kansas City, KS
- NPI 1649259656
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151280000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1323216000000",
"number": "1861429979",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 419380 - DEPT 128",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "641416380",
"telephone_number": "913-642-4900",
"fax_number": "913-381-0979"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2800 CLAY EDWARDS DR",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "641163220",
"telephone_number": "816-691-5201"
}
],
"practiceLocations": [],
"basic": {
"last_name": "UNDERWOOD",
"first_name": "JOHNSON",
"name_prefix": "Dr.",
"name_suffix": "IV",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-26",
"last_updated": "2011-12-07",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "MO",
"license": "112408",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "300074147",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1861429979",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100299860A",
"state": "KS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "5087570",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSKC",
"identifier": "24439012",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CMFHP",
"identifier": "14730",
"state": "MO"
}
],
"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 Dec 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.