Active NPI
Jean M Stork, RD
- Registered Dietitian
- Kansas City, KS
National Provider Identifier
1912237991
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 1438
- Practice address
- Center for Child Health and Development
3901 Rainbow Blvd., MSN 4003
Kansas City, KS 66160-0001 - Phone
- (913) 945-6677
- Fax
- (913) 588-8568
- NPI assigned
- Jan 13, 2010
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 1438 | KS | Primary |
Addresses
Primary practice location
Center for Child Health and Development
3901 Rainbow Blvd., MSN 4003
Kansas City, KS 66160-0001
Mailing address
Center for Child Health and Development
3901 Rainbow Blvd., MSN 4003
Kansas City, KS 66160-0001
Phone (913) 945-6677
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200639390 A | Medicaid | KS |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1438 | KS | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1263340800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1407456000000",
"number": "1912237991",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "CENTER FOR CHILD HEALTH AND DEVELOPMENT",
"address_2": "3901 RAINBOW BLVD., MSN 4003",
"city": "KANSAS CITY",
"state": "KS",
"postal_code": "661600001",
"telephone_number": "913-945-6677",
"fax_number": "913-588-8568"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "CENTER FOR CHILD HEALTH AND DEVELOPMENT",
"address_2": "3901 RAINBOW BLVD., MSN 4003",
"city": "KANSAS CITY",
"state": "KS",
"postal_code": "661600001",
"telephone_number": "913-945-6677",
"fax_number": "913-588-8568"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STORK",
"first_name": "JEAN",
"middle_name": "M",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-01-13",
"last_updated": "2014-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "KS",
"license": "1438",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200639390 A",
"state": "KS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kansas City, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.