PRIME HEALTHCARE PHYSICIAN SERVICES - PROVIDENCE INC (NPI# 1356683213) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356683213 |
| Entity Type | Organization |
| Organization Name | PRIME HEALTHCARE PHYSICIAN SERVICES - PROVIDENCE INC |
| Other Organization Name | PROVIDENCE MEDICAL GROUP |
| Practice Address |
8929 Parallel Pkwy Kansas City KS 66112-1689 |
| Practice Telephone | 9135963930 |
| Practice Fax Number | 9135964098 |
| Mailing Telephone | 9135963930 |
| Mailing Fax Number | 9135964098 |
| Enumeration Date | 2013-03-19 |
| Last Update Date | 2020-11-04 |
| Authorized Official Name | CHRISTOPHER DOAN (MANAGING ASSOCIATE GENERAL COUNSEL) |
| Authorized Official Telephone | 3102594706 |
| Is Organization Subpart | Y |
| Parent Organization Name | PRIME HEALTHCARE SERVICES, INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 204E00000X | Oral & Maxillofacial Surgery | Allopathic & Osteopathic Physicians | ||
| N | 207L00000X | Anesthesiology | Allopathic & Osteopathic Physicians | ||
| N | 207LP2900X |
Anesthesiology Specialization: Pain Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians | ||
| N | 207VF0040X |
Obstetrics & Gynecology Specialization: Female Pelvic Medicine and Reconstructive Surgery |
Allopathic & Osteopathic Physicians | ||
| N | 207X00000X | Orthopaedic Surgery | Allopathic & Osteopathic Physicians | ||
| N | 2083P0011X |
Preventive Medicine Specialization: Undersea and Hyperbaric Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
Allopathic & Osteopathic Physicians | ||
| N | 208600000X | Surgery | Allopathic & Osteopathic Physicians | ||
| N | 2086S0120X |
Surgery Specialization: Pediatric Surgery |
Allopathic & Osteopathic Physicians | ||
| Y | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 500017218 | 05 | |
| KS | 201193920H | 05 |
| Other Name | Type Code |
|---|---|
| Providence Medical Group | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1420 S 42nd St, Kansas City, KS 661061952 | 9138311100 | |
| 15604 Pinehurst Dr Ste 2, Basehor, KS 660078234 | 9137282200 | |
| 3500 S 4th St, Leavenworth, KS 660485043 | 9136806000 | |
| 3550 S 4th St Ste 115, Leavenworth, KS 660485061 | 9135967224 | |
| 3550 S 4th St Ste 200, Leavenworth, KS 660485009 | 9136806442 | |
| 3550 S 4th Street, Saint John Outpatient Surgery, Leavenworth, KS 66048 | 9136806000 | |
| 7255 Renner Rd, Shawnee, KS 662173043 | 9133346800 | |
| 8101 Parallel Pkwy Ste 100, Kansas City, KS 661122067 | 9132999200 | |
| 8919 Parallel Pkwy Ste 121, Kansas City, KS 661121655 | 9135967230 | 9135967228 |
| 8919 Parallel Pkwy Ste 206, Kansas City, KS 661121655 | 9133346800 | |
| 8919 Parallel Pkwy Ste 416, Kansas City, KS 661121655 | 9135965104 | |
| 8919 Parallel Pkwy Ste 440, Kansas City, KS 661121655 | 9135967286 | |
| 8919 Parallel Pkwy Ste 455, Kansas City, KS 661123628 | 9135964929 | |
| 8919 Parallel Pkwy Ste 555, Kansas City, KS 661123628 | 9135963940 | 9135963730 |
| 8919 Parallel Pkwy Ste 580, Kansas City, KS 661121655 | 9135967224 | |
| 913 Sheidley Ave, Bonner Springs, KS 660129514 | 9133227222 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972119741 | Prime Healthcare Physician Services - Providence Inc | General Practice | 3550 So 4th St, Ste B, Leavenworth, KS 66048 | 2020-09-17 |
| Street Address |
8929 PARALLEL PKWY |
| City | KANSAS CITY |
| State | KS |
| Zip Code | 66112-1689 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710981451 | William Henry Brooks | Radiology | 8929 Parallel Pkwy, Kansas City, KS 66112-1689 | 2005-06-10 |
| 1356964076 | Manraj Chahal | Student in an Organized Health Care Education/Training Program | 8929 Parallel Pkwy, Kansas City, KS 66112-3607 | 2020-05-28 |
| 1124663646 | Psychiatric Care Professionals P.a | Psychiatry & Neurology | 8929 Parallel Pkwy, Kansas City, KS 66112-1689 | 2019-11-07 |
| 1568957249 | Stephanie Murphy | Nurse Practitioner | 8929 Parallel Pkwy, Kansas City, KS 66112-1689 | 2018-06-26 |
| 1831680842 | Deanna Marie Bafus | Clinical Nurse Specialist | 8929 Parallel Pkwy, Kansas City, KS 66112-1689 | 2018-05-24 |
| 1679079487 | App of Kansas Ed, Pllc | Emergency Medicine | 8929 Parallel Pkwy, Kansas City, KS 66112-1689 | 2018-04-02 |
| 1245747005 | Carla Shepard | Nurse Practitioner | 8929 Parallel Pkwy, Kansas City, KS 66112-1689 | 2018-01-02 |
| 1891226031 | Paul Anthony Middleton | Family Medicine | 8929 Parallel Pkwy, Kansas City, KS 66112-1689 | 2017-03-21 |
| 1124568498 | Andrew P Crow | Emergency Medicine | 8929 Parallel Pkwy, Kansas City, KS 66112-1689 | 2017-03-06 |
| 1639624364 | Prime Healthcare Services-providence, LLC | Skilled Nursing Facility | 8929 Parallel Pkwy, Kansas City, KS 66112-1689 | 2016-08-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740610328 | Diana Alejandra Williams | Social Worker | 7940 Parallel Parkway Ste 2, Kansas City, KS 66112 | 2013-11-19 |
| 1316375835 | Angela Candelario | Social Worker | 7840 Washington Avenue, Kansas City, KS 66112 | 2013-10-18 |
| 1982909891 | Mark Joshua Foland | Emergency Medicine | 8929 Parallel Parwkay, Attn: Emergency Department, Kansas City, KS 66112 | 2011-01-24 |
| 1457655623 | Alvin Edward Johnson | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 9003 Barnett Ave., Kansas City, KS 66112 | 2011-01-03 |
| 1437383437 | Kurtis Clifton Springstead | Physical Therapist | 7925 State Ave Ste 104, Kansas City, KS 66112 | 2009-05-06 |
| 1215133293 | Linda L Clarkson | Physical Therapy Assistant | Kansas City Presbyterian Manor, 78th and Freeman, Kansas City, KS 66112 | 2007-06-26 |
| 1104033364 | Eric D. Hyde | Physical Therapist | 8929 Parallel Parway, Providence Medical Center-rehabilitation Department, Kansas City, KS 66112 | 2007-05-17 |
| 1578781498 | Kristi Lyn Weaver Rowe | Obstetrics & Gynecology | 8919 Parallel, Ste 580, Women's Clinic Associates, Kansas City, KS 66112 | 2007-04-23 |
| 1346464708 | Souvenir Culanculan Rivera | Nurse Practitioner | Providence Medical Center, 8929 Parallel Parkway, Kansas City, KS 66112 | 2007-04-13 |
| 1205961919 | Mcbratney Optical Boutique | Technician/Technologist | 7702 Parallel Parkway, Kansas City, KS 66112 | 2007-02-22 |
| Find all providers in zip 66112 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740784214 | Bridge Integrative Medicine LLC | General Practice | 305 Nw Englewood Ct Ste 200, Kansas City, MO 64118 | 2018-03-20 |
| 1629310370 | Sarah Jane Beck | General Practice | 4332 Harrison St, Kansas City, MO 64110-1626 | 2013-03-20 |
| 1366714404 | Premise Health of Missouri Medical P C | General Practice | 9450 Ward Pkwy, Kansas City, MO 64114-3319 | 2012-02-06 |
| 1083833677 | Arthur Paul Greenberg | General Practice | 2004 Nw 82nd Ct, Kansas City, MO 64151-3763 | 2007-04-24 |
| 1235251331 | Carlos Arnoldo Fierro | General Practice | 226 N 7th St, Kansas City, KS 66101-3202 | 2007-04-06 |
| 1497831267 | Charles John Rudolph Jr. | General Practice | 2800 Kendallwood Parkway, Suite A, Kansas City, MO 64119 | 2006-10-27 |
| 1265465363 | Northland Medical and Wellness Center LLC | General Practice | 8355 Nw Barrybrooke Dr, Kansas City, MO 64151-1024 | 2006-07-09 |
| 1255387866 | United Medical Group, LLC | General Practice | 5701 State Ave, Suite 100, Kansas City, KS 66102-1236 | 2006-05-25 |
| 1720055668 | Coatney Clinic, Inc | General Practice | 6235 E Truman Rd, Kansas City, MO 64126-2631 | 2006-02-28 |
| 1811552029 | Georgeanne Emerson Cornell | General Practice | 2301 Holmes Street, Kansas City, MO 64108 | 2019-05-02 |
| Find all providers in KANSAS CITY | ||||
| City | KANSAS CITY |
| Zip Code | 66112 |
Please comment or provide details below to improve the information on PRIME HEALTHCARE PHYSICIAN SERVICES - PROVIDENCE INC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.