Provider Demographics
NPI:1194068882
Name:VERHAEGHE, REBECCA NICOLETTE (DO)
Entity type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:NICOLETTE
Last Name:VERHAEGHE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11600 COLLEGE BLVD
Mailing Address - Street 2:STE 201
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210
Mailing Address - Country:US
Mailing Address - Phone:913-310-0225
Mailing Address - Fax:913-310-0565
Practice Address - Street 1:10500 QUIVIRA RD
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66215-2306
Practice Address - Country:US
Practice Address - Phone:913-310-0225
Practice Address - Fax:913-310-0565
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-01
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016026401208000000X
KS05-418992080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal MedicineGroup - Single Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO200034427Medicaid
KS201238780AMedicaid