MEDICARE: KOURTNEY RAE BETTINGER M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	04-39055	KS

General Provider Information

NPI Number	:	1801139787
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KOURTNEY RAE BETTINGER M.D.

Provider Business Mailing Address
First Line	:	2106 OLATHE BLVD MS 4004
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66160-0001
Country	:	US
Telephone Number	:	913-588-6300
Fax Number	:	913-274-3515

Provider Business Practice Location Address
First Line	:	2000 OLATHE
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66160-2581
Country	:	US
Telephone Number	:	913-588-6300
Fax Number	:	913-274-3515

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/29/2013
Last Update Date	:	08/18/2025

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