Healthcare Provider Details

I. General information

NPI: 1366671422
Provider Name (Legal Business Name): JASON KYLE BESSEY D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2009
Last Update Date: 11/03/2025
Certification Date: 11/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4550 W 109TH ST STE 200
OVERLAND PARK KS
66211-1354
US

IV. Provider business mailing address

5101 COLLEGE BLVD
LEAWOOD KS
66211-1614
US

V. Phone/Fax

Practice location:
  • Phone: 913-721-3387
  • Fax: 816-875-2597
Mailing address:
  • Phone: 816-478-4200
  • Fax: 816-875-2597

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number05-38981
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2014029484
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: