Organization Active NPI

Elysian Wellness Campus LLC

  • Internal Medicine Physician
  • Kansas City, MO
National Provider Identifier
1972499648
Registry record updated Feb 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
ELYSIAN WELLNESS CAMPUS LLC
Practice address
2460 Brooklyn Ave
Kansas City, MO 64127-3819
Phone
(336) 558-6198
NPI assigned
Jun 17, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2026

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

Authorized official

Name
Dr. Chereena Walker, DONPI 1457703530
Title
Owner/Ceo
Phone
(816) 300-3386

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
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

2460 Brooklyn Ave
Kansas City, MO 64127-3819

Mailing address

2460 Brooklyn Ave
Kansas City, MO 64127-3819
Phone (816) 300-3386

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260318001232 MO Part B Supplier - Clinic/Group Practice 3779067780 Receives reassigned benefits from 1 practitioner
Practice locations: Kansas City, MO

National Provider Directory

National Provider Directory

Locations

2460 Brooklyn Ave
Kansas City, MO 64127
Phone (336) 558-6198

Practitioners & affiliated clinicians

Practitioners 1

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": "1750118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771286400000",
    "number": "1972499648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2460 BROOKLYN AVE",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641273819",
            "telephone_number": "816-300-3386",
            "fax_number": "816-603-2754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2460 BROOKLYN AVE",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641273819",
            "telephone_number": "336-558-6198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELYSIAN WELLNESS CAMPUS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-17",
        "last_updated": "2026-02-17",
        "certification_date": "2026-02-17",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "CHEREENA",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "816-300-3386",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Feb 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.