Healthcare Provider Details

I. General information

NPI: 1013172022
Provider Name (Legal Business Name): KRISTOPHER SHAWN LYBARGER D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2008
Last Update Date: 03/02/2026
Certification Date: 03/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2340 E MEYER BLVD BLDG 2 STE 546
KANSAS CITY MO
64132-1105
US

IV. Provider business mailing address

2340 E MEYER BLVD BLDG 2 STE 546
KANSAS CITY MO
64132-1105
US

V. Phone/Fax

Practice location:
  • Phone: 816-926-0777
  • Fax: 816-926-0707
Mailing address:
  • Phone: 816-926-0777
  • Fax: 816-926-0707

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number2015025644
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberOS015980
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number0538312
License Number StateKS
# 4
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number5101017678
License Number StateMI
# 5
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number012192
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: