Provider Demographics
NPI:1508814559
Name:BYBEE, KEVIN A (MD)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:A
Last Name:BYBEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4330 WORNALL RD
Mailing Address - Street 2:SUITE 2000
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64111-5939
Mailing Address - Country:US
Mailing Address - Phone:816-931-1883
Mailing Address - Fax:816-756-3645
Practice Address - Street 1:4330 WORNALL RD
Practice Address - Street 2:SUITE 2000
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-5939
Practice Address - Country:US
Practice Address - Phone:816-931-1883
Practice Address - Fax:816-756-3645
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2011-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-31101207UN0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOP00842655OtherRAILROAD MEDICARE
KS200310710EMedicaid
MO209470202Medicaid
KS200310710CMedicaid
KS200310710AMedicaid
KS200310710FMedicaid
KSP00832500OtherRAILROAD MEDICARE
MOMA2492028Medicare PIN
MOP00842655OtherRAILROAD MEDICARE
KS200310710EMedicaid
KSKA2004005Medicare PIN
MOMA2491028Medicare PIN