Individual provider Active NPI

Kayron Aliece Bradley, M.D.

  • Pediatrics Physician
  • Kansas City, KS
National Provider Identifier
1962798207
Registry record updated Jan 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
0437559 Issued in KS
Practice address
2040 Hutton Rd Ste 102
Kansas City, KS 66109-4566
Phone
(913) 299-3700
NPI assigned
Jun 24, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 2011017845 MO
Pediatrics Physician 208000000X 2013030300 MO
Pediatrics Physician 208000000X 0437559 KS Primary

Addresses

Primary practice location

2040 Hutton Rd Ste 102
Kansas City, KS 66109-4566

Mailing address

2040 Hutton Rd Ste 102
Kansas City, KS 66109-4566
Phone (913) 299-3700

Other names 1

  • Kayron Aliece Kelly Former name

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
0437559KSMDPediatrics Physician
2011017845MOMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Shawnee Mission Medical Center Inc Past Accepting new patients
Sunflower Medical Group PA Pediatrics Past Accepting new patients
Midwest Division-Oprmc LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kayronbradley@smgks.allscriptsdirect.net

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": "1308873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453248000000",
    "number": "1962798207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2040 HUTTON RD STE 102",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661094566",
            "telephone_number": "913-299-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2040 HUTTON RD STE 102",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661094566",
            "telephone_number": "913-299-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "KAYRON",
        "middle_name": "ALIECE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-24",
        "last_updated": "2016-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MO",
            "license": "2011017845",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2013030300",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KS",
            "license": "0437559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAYRON",
            "last_name": "KELLY",
            "middle_name": "ALIECE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Jan 20, 2016; 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.