Individual provider Active NPI

Brian D Fagan, M.D.

  • Surgery Physician
  • Kansas City, MO
National Provider Identifier
1881634210
Registry record updated Aug 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
R3M20 Issued in MO
Practice address
373 W 101St Ter
Suite 210
Kansas City, MO 64114-4408
Phone
(816) 333-9500
Fax
(816) 363-3700
NPI assigned
Jun 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X R3M20 MO Primary

Addresses

Primary practice location

373 W 101St Ter
Suite 210
Kansas City, MO 64114-4408

Mailing address

373 W 101St Ter
Suite 210
Kansas City, MO 64114-4408
Phone (816) 333-9500

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
56248CAMDPharmacist
R3M20MOMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Town Plaza Family Practice LLC Past Accepting new patients
Rockhill General Surgery LLC Surgery Past Accepting new patients
Menorah Family Physicians LLC Past Accepting new patients
Midwest Medicine Associates LLC Past Accepting new patients

Organizations & group practices 4

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": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186358400000",
    "number": "1881634210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "373 W 101ST TER",
            "address_2": "SUITE 210",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641144408",
            "telephone_number": "816-333-9500",
            "fax_number": "816-363-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "373 W 101ST TER",
            "address_2": "SUITE 210",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641144408",
            "telephone_number": "816-333-9500",
            "fax_number": "816-363-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAGAN",
        "first_name": "BRIAN",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2007-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MO",
            "license": "R3M20",
            "primary": true
        }
    ],
    "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 Aug 6, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.