Healthcare Provider Details

I. General information

NPI: 1013667724
Provider Name (Legal Business Name): ADDISON BAILEY WITT DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2022
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 OLATHE BLVD MAILSTOP 4004
KANSAS CITY KS
66160
US

IV. Provider business mailing address

4000 CAMBRIDGE ST
KANSAS CITY KS
66160-8501
US

V. Phone/Fax

Practice location:
  • Phone: 913-588-6300
  • Fax:
Mailing address:
  • Phone: 913-588-6300
  • Fax: 913-274-3515

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number05-53649
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number036172248
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: