Provider Demographics
NPI:1285671784
Name:BELSHE, KENNA K (DO)
Entity Type:Individual
Prefix:
First Name:KENNA
Middle Name:K
Last Name:BELSHE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:KENNA
Other - Middle Name:KATHLEEN
Other - Last Name:ADIGA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2700 CLAY EDWARDS DR
Mailing Address - Street 2:SUITE 240
Mailing Address - City:NORTH KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64116-3251
Mailing Address - Country:US
Mailing Address - Phone:816-455-0681
Mailing Address - Fax:816-455-5294
Practice Address - Street 1:2700 CLAY EDWARDS DR
Practice Address - Street 2:SUITE 240
Practice Address - City:NORTH KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64116-3251
Practice Address - Country:US
Practice Address - Phone:816-455-0681
Practice Address - Fax:816-455-5294
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2018-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004009977207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1285671784Medicaid
MOP01754984Medicare PIN
MOMA6411005Medicare PIN
MO7451791OtherAETNA HEALTHCARE
I44883Medicare UPIN
MO033598OtherFAMILY HEALTH PARTNERS
MO64740OtherHEALTHCARE USA
MO765E207Medicare PIN
MO000259720903OtherUNITED HEALTRH CARE
MO144883Medicare UPIN
MO207273004Medicaid