Provider Demographics
NPI:1669477204
Name:FEASTER, HUNTER TODD (PSYD)
Entity Type:Individual
Prefix:DR
First Name:HUNTER
Middle Name:TODD
Last Name:FEASTER
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8550 MARSHALL DR
Mailing Address - Street 2:STE 100
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66214-1505
Mailing Address - Country:US
Mailing Address - Phone:913-894-1500
Mailing Address - Fax:913-894-1502
Practice Address - Street 1:8550 MARSHALL DR
Practice Address - Street 2:STE 100
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66214-1505
Practice Address - Country:US
Practice Address - Phone:913-894-1500
Practice Address - Fax:913-894-1502
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2007-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSLP1161103G00000X
MO2002007821103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
30946011OtherBCBS KANSAS CITY
542516OtherHEALTHLINK-NCPPO
2098885OtherCIGNA BEHAVIORAL
10001037600OtherCOMMUNITY HEALTH PLAN MO
542516OtherHEALTHLINK-NCPPO
KS623B648BMedicare ID - Type Unspecified
MO623B648Medicare ID - Type Unspecified