Healthcare Provider Details

I. General information

NPI: 1215916143
Provider Name (Legal Business Name): STEVEN DEANE SEGRAVES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2006
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8900 STATE LINE RD STE 380
LEAWOOD KS
66206-1936
US

IV. Provider business mailing address

8900 STATE LINE RD STE 380
LEAWOOD KS
66206-1936
US

V. Phone/Fax

Practice location:
  • Phone: 913-385-7252
  • Fax:
Mailing address:
  • Phone: 913-385-7252
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License NumberR3K75
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberR3K75
License Number StateMO
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number0422732
License Number StateKS
# 4
Primary TaxonomyN
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number0422732
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: