Active NPI
Kayron Aliece Bradley, M.D.
- Pediatrics Physician
- Kansas City, KS
National Provider Identifier
1962798207
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 0437559
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0437559 | KS | MD | Pediatrics Physician |
| 2011017845 | MO | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New 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
- 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.
-
- General Acute Care Hospital
- Overland Park, KS
- NPI 1578500484
-
- General Acute Care Hospital
- Merriam, KS
- NPI 1023171634
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.