Healthcare Provider Details

I. General information

NPI: 1497332902
Provider Name (Legal Business Name): RACHEL OLDFATHER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2021
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7840 W 165TH ST STE 210
OVERLAND PARK KS
66223-2993
US

IV. Provider business mailing address

7840 W 165TH ST STE 210
OVERLAND PARK KS
66223-2993
US

V. Phone/Fax

Practice location:
  • Phone: 913-373-2230
  • Fax: 913-373-0999
Mailing address:
  • Phone: 913-373-2230
  • Fax: 913-373-0999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number04-51441
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number04-51441
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: