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Contact Information

KELLI J ANDRESEN, MD
4401 WORNALL RD
RADIOLOGY DEPT
KANSAS CITY, MO64111-3220
 Phone: 816-932-2000
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Diagnostic Radiology

2085R0202X 30 Physician/Diagnostic Radiology
Indicates primary specialty

NPI Profile & details for KELLI J ANDRESEN · (Female)

NPI Number 1073597514
Status Active
Credentials MD
Entity Individual
Enumeration date 11/29/2005
Last updated 12/01/2017 - About 9 years ago
Sole proprietor 1 No
Identifiers
  • IA License # 36297
  • MO License # 2008002389
  • IA Medicaid 0472795
  • KS Medicaid 200564680A
  • MO Medicaid 1073597514
  • IA Other 39890 WELLMARK BCBS
  • MO Other 37843017 BCBS KANSAS CITY
  • MO Other 37843027 BCBS KC GRP# 18959016
  • MO Other P00475714 RAILROAD MEDICARE
Hospital affiliation(s)
  • GREAT BEND REGIONAL HOSPITAL - (Acute Care)
    514 CLEVELAND STREET
    GREAT BEND, KS 67530
  • UNIVERSITY OF KANSAS HOSPITAL - (Acute Care)
    3901 RAINBOW BLVD
    KANSAS CITY, KS 66103
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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