NPIMap

Individual provider Active NPI

Roger R Ivey, MD

  • Diagnostic Radiology Physician
  • Kansas City, MO
National Provider Identifier
1982630356
Registry record updated Nov 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
2000152085 Issued in MO
Practice address
2800 Clay Edwards Dr
Kansas City, MO 64116-3220
Phone
(816) 691-5201
NPI assigned
Jun 25, 2006
Last updated
Nov 17, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 2000152085 MO Primary

Addresses

Primary practice location

2800 Clay Edwards Dr
Kansas City, MO 64116-3220

Mailing address

PO Box 419380
Dept. 128
Kansas City, MO 64141-6380
Phone (913) 642-4900

Other identifiers 6

IdentifierTypeStateIssuer
300121246OtherMORR MEDICARE
43740OtherMOCMFHP
27367018OtherMOBCBSKC
5042768OtherMOAETNA
1982630356MedicaidMO
100345960BMedicaidKS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100503000342 MO Practitioner - Diagnostic Radiology 5597854091 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Missouri, Columbia School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northland Radiology IncGroup PAC ID 4284689043, 15 clinicians

Practice addresses (Care Compare)

2800 Clay Edwards Dr
N Kansas City, MO 64116-3220
Phone (913) 642-4900

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2000152085MOMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northland Radiology, Inc. Diagnostic Radiology CurrentSince Jul 1, 2000 Accepting new patients
North Kansas City Hospital PastSince Jul 1, 2000 Accepting new patients

Locations

5501 NW 62nd Ter
Ste 200
Kansas City, MO 64151
Phone (816) 691-1333

9501 N Oak Trfy
Kansas City, MO 64155
Phone (816) 455-0661

2800 Hospital Dr
North Kansas City, MO 64116
Phone (816) 221-5050

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/MtxVU3dbzZwHcvfCb2vTAE2_Nwhai9Oq/

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1151193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416182400000",
    "number": "1982630356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 419380",
            "address_2": "DEPT. 128",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641416380",
            "telephone_number": "913-642-4900",
            "fax_number": "913-381-0979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 CLAY EDWARDS DR",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641163220",
            "telephone_number": "816-691-5201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVEY",
        "first_name": "ROGER",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-25",
        "last_updated": "2014-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MO",
            "license": "2000152085",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "300121246",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CMFHP",
            "identifier": "43740",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSKC",
            "identifier": "27367018",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5042768",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1982630356",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100345960B",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.