Wellspring Healthcare LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

WELLSPRING HEALTHCARE LLC

Practice address

6124 Raytown Rd
Raytown, MO 64133-4007

Phone

(909) 815-3324

NPI assigned

Sep 11, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Brian Moore Haas, DONPI 1033352463

Title

Ceo

Phone

(909) 815-3324

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Wellspring Healthcare LLC

  • Primary Care Clinic/Center
  • Shawnee Mission, KS
  • NPI 1659191054

  9032509088

  Same PAC ID

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Brian Moore Haas, D.O

  • Internal Medicine Physician
  • Kansas City, MO
  • NPI 1033352463
  Medicare reassignment Authorized official
• Michele Duckett, AGNP

  • Gerontology Nurse Practitioner
  • Independence, MO
  • NPI 1427698224
  Medicare reassignment NPD
• Hannah Pearl Neenan, N.P.

  • Family Nurse Practitioner
  • Kansas City, MO
  • NPI 1750627352
  Medicare reassignment
• Preeti Sood, M.D.

  • Internal Medicine Physician
  • Kansas City, MO
  • NPI 1245464395
  Medicare reassignment

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

{
    "created_epoch": "1631318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662076800000",
    "number": "1881363927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705B SE MELODY LN # 184",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640634380",
            "telephone_number": "909-815-3324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6124 RAYTOWN RD",
            "city": "RAYTOWN",
            "state": "MO",
            "postal_code": "641334007",
            "telephone_number": "909-815-3324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLSPRING HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-11",
        "last_updated": "2022-09-02",
        "certification_date": "2022-09-02",
        "status": "A",
        "authorized_official_last_name": "HAAS",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "MOORE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "909-815-3324",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aries M Washington, MA, LPC
• Jennifer Watts, LPC
• Cyndi Dianne Weaver, COTA
• Quincella Webb
• Laura L. Weisenborn
• Traci Lynn Wentz, PMHNP-BC
• Shawn R. Wesson, LCSW
• Westridge Gardens Nursing & Rehabilitation Center, LLC
• Rebecca R White, P.T.
• Wildwood Cottage

• Internal Medicine Physician in Raytown, MO
• Providers in Raytown, MO by specialty
• Internal Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.