Organization Active NPI

Midwest Regional Telehealth LLC

  • General Practice Physician
  • Lees Summit, MO
National Provider Identifier
1992324768
Registry record updated Feb 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
MIDWEST REGIONAL TELEHEALTH LLC
Practice address
931 SW Lemans LN
Lees Summit, MO 64082-4619
Phone
(816) 708-8853
Fax
(816) 623-3076
NPI assigned
Apr 13, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2024

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

Authorized official

Name
Mrs. Lisa M McMillin
Title
Office Manager
Phone
(816) 708-8853

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

931 SW Lemans LN
Lees Summit, MO 64082-4619

Mailing address

931 SW Lemans LN
Lees Summit, MO 64082-4619
Phone (816) 708-8853

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240327003689 MO Part B Supplier - Clinic/Group Practice 9436596236 Receives reassigned benefits from 1 practitioner
Practice locations: Lees Summit, MO

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1586736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707091200000",
    "number": "1992324768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "931 SW LEMANS LN",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640824619",
            "telephone_number": "816-708-8853",
            "fax_number": "816-623-3076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "931 SW LEMANS LN",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640824619",
            "telephone_number": "816-708-8853",
            "fax_number": "816-623-3076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST REGIONAL TELEHEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-13",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-05",
        "status": "A",
        "authorized_official_last_name": "MCMILLIN",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "816-708-8853",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lees Summit, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2024; 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.