NPIMap

Organization Active NPI

KC Bariatric, LLC

  • Surgery Physician
  • Lenexa, KS
National Provider Identifier
1992945307
Registry record updated Aug 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
KC BARIATRIC, LLC
Practice address
23401 Prairie Star Parkway
Suite B-300
Lenexa, KS 66227
Phone
(913) 677-6319
Fax
(913) 677-1540
NPI assigned
Feb 25, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2024

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

Authorized official

Name
Cheryl A Wenz
Title
Director of Credentialing
Phone
(913) 677-6319

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

23401 Prairie Star Parkway
Suite B-300
Lenexa, KS 66227

Mailing address

PO Box 7913
Carol Stream, IL 60197-7913
Phone (913) 677-6319

Other practice location 1

23351 Prairie Star Pkwy Ste A305
Lenexa, KS 66227-7376
Phone (913) 677-6319

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090323000514 KS Part B Supplier - Clinic/Group Practice 3375600182 Receives reassigned benefits from 21 practitioners
Practice locations: Lenexa, KS

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
17D2217035KC Bariatric, LLC23401 Prairie Star Pkwy Suite 300, Lenexa, KS 66227ComplianceSep 26, 2027

National Provider Directory

National Provider Directory

Locations

7415 Grandview St
Shawnee Mission, KS 66204
Phone (913) 676-2253

Practitioners & affiliated clinicians

Practitioners 27

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1235520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722816000000",
    "number": "1992945307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7913",
            "city": "CAROL STREAM",
            "state": "IL",
            "postal_code": "601977913",
            "telephone_number": "913-677-6319",
            "fax_number": "913-677-1540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23401 PRAIRIE STAR PARKWAY",
            "address_2": "SUITE B-300",
            "city": "LENEXA",
            "state": "KS",
            "postal_code": "66227",
            "telephone_number": "913-677-6319",
            "fax_number": "913-677-1540"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "23351 Prairie Star Pkwy Ste A305",
            "address_purpose": "LOCATION",
            "city": "Lenexa",
            "state": "KS",
            "postal_code": "662277376",
            "country_code": "US",
            "telephone_number": "913-677-6319",
            "fax_number": "913-677-1540",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KC BARIATRIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-25",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A",
        "authorized_official_last_name": "WENZ",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DIRECTOR OF CREDENTIALING",
        "authorized_official_telephone_number": "913-677-6319"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lenexa, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 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.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.