Organization Active NPI

Independence Pediatrics, P.C. Inc.

  • Specialist
  • Independence, MO
National Provider Identifier
1962532283
Registry record updated Mar 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
35496 Issued in MO
Legal business name
INDEPENDENCE PEDIATRICS, P.C. INC.
Practice address
4731 S Cochise Dr Ste 100
Independence, MO 64055-6975
Phone
(816) 373-1111
Fax
(816) 373-9222
NPI assigned
Mar 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2025

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

Authorized official

Name
Dr. Weldon Lee Harris, M.D.NPI 1548201106
Title
Primary Care Physician
Phone
(816) 373-1111

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 35496 MO Primary

Addresses

Primary practice location

4731 S Cochise Dr Ste 100
Independence, MO 64055-6975

Mailing address

4731 S Cochise Dr Ste 100
Independence, MO 64055-6975
Phone (816) 373-1111

Other practice location 1

2 NE Sycamore St
Lees Summit, MO 64086-9578
Phone (816) 373-1111

Other identifiers 2

IdentifierTypeStateIssuer
J61A008MedicaidMO
J619948MedicaidMO

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
26D0901843Independence Pediatrics4731 S Cochise Dr, Suite 100, Independence, MO 64055Certificate of waiverOct 3, 2026

National Provider Directory

National Provider Directory
Tax ID family
Independence Pediatrics2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2 NE Sycamore St
Lees Summit, MO 64086
Phone (816) 373-1111

Practitioners & affiliated clinicians

Practitioners 7

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

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741910400000",
    "number": "1962532283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4731 S COCHISE DR STE 100",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640556975",
            "telephone_number": "816-373-1111",
            "fax_number": "816-373-9222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4731 S COCHISE DR STE 100",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640556975",
            "telephone_number": "816-373-1111",
            "fax_number": "816-373-9222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 NE Sycamore St",
            "address_purpose": "LOCATION",
            "city": "Lees Summit",
            "state": "MO",
            "postal_code": "640869578",
            "country_code": "US",
            "telephone_number": "816-373-1111",
            "fax_number": "816-373-9222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "INDEPENDENCE PEDIATRICS, P.C. INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-06",
        "last_updated": "2025-03-14",
        "certification_date": "2025-03-14",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "WELDON",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PRIMARY CARE PHYSICIAN",
        "authorized_official_telephone_number": "816-373-1111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "MO",
            "license": "35496",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "J61A008",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "J619948",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Independence, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.

Verify at the official NPI Registry.