Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Timothy C Stallard, PA

Individual provider Surgical Physician Assistant · NPI 1679536148

Mr. Timothy C Stallard, PA is a Physician Assistant in Lenexa, Kansas. Qualified in 1994, 32 years ago. Practices with Kc Bariatric LLC, a 16-clinician group and offers telehealth. Licensed in Kansas.

Years since qualifying
32
Licensed in
KS
In the registry since
2006
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

See every abbreviation used in this directory →

Practice location Address checks out

23401 Prairie Star Pkwy Ste 300
Lenexa, KS 66227-7268
Phone: (913) 677-6319
Fax: (913) 677-1540
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence 1500547 (KS)

Record details

NPI number1679536148
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedApril 7, 2006
Last updated in NPPESMarch 24, 2025
Certification dateMarch 24, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 1994 (32 years in practice)
Group practice Kc Bariatric Llc — 16 clinicians
Accepts Medicare assignment Not indicated
TelehealthOffers telehealth services
Practice locations4 on file with Medicare

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