Individual provider Active NPI

Robert V Spake, M.D.

  • Otolaryngology Physician
  • Kansas City, MO
National Provider Identifier
1932160942
Registry record updated Dec 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
R9097 Issued in MO
Practice address
4320 Wornall Rd
Ste 512
Kansas City, MO 64111-5941
Phone
(816) 932-8663
NPI assigned
Mar 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X R9097 MO Primary

Addresses

Primary practice location

4320 Wornall Rd
Ste 512
Kansas City, MO 64111-5941

Mailing address

901 E 104TH St
Mailstop 400S
Kansas City, MO 64131-4517
Phone (816) 502-8755

Other identifiers 1

IdentifierTypeStateIssuer
1932160942MedicaidMO

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
R9097MOMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Shasta Regional Medical Center, LLC Past Accepting new patients
Shasta ENT Specialists Otolaryngology PastSince Jan 1, 2007 Accepting new patients
St Lukes Hospital of Kansas City Otolaryngology Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: rspake4137@direct.saint-lukes.org

Organizations & group practices 3

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": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512086400000",
    "number": "1932160942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 E 104TH ST",
            "address_2": "MAILSTOP 400S",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641314517",
            "telephone_number": "816-502-8755",
            "fax_number": "816-932-9670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4320 WORNALL RD",
            "address_2": "STE 512",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641115941",
            "telephone_number": "816-932-8663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPAKE",
        "first_name": "ROBERT",
        "middle_name": "V",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-29",
        "last_updated": "2017-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MO",
            "license": "R9097",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1932160942",
            "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 1, 2017; 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.