# KCPEDSRD LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1548989502
- **Authorized official:** MRS. ALEXANDRA MAE GREGG RD, LD (DIETITIAN)
- **Authorized official phone:** (816) 875-0077

## Contact information

- **Practice address:** 2420 SW WINTERFIELD CT, LEES SUMMIT, MO 64081-4098
- **Practice address phone:** (816) 875-0077
- **Mailing address:** 8450 NW PRAIRIE VIEW RD \# 1441, KANSAS CITY, MO 64153-1841
- **Mailing address phone:** (816) 875-0077
- **Mailing address fax:** (507) 322-1832

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 08/24/2022
- **Last updated:** 11/08/2022