MARY BRULJA (NPI# 1548664626) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548664626 |
| Entity Type | Individual |
| Full Name | MARY BRULJA |
| Credential | D.O. |
| Practice Address |
20 Ne Saint Lukes Blvd Ste 310 Lees Summit MO 64086-6001 |
| Mailing Address |
5701 W 119th St Ste 225 Overland Park KS 66209-3721 |
| Practice Telephone | 8162827809 |
| Practice Fax Number | 8162827870 |
| Mailing Telephone | (913) 601-4020 |
| Enumeration Date | 2014-10-17 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | 2017011922 | MO | Allopathic & Osteopathic Physicians |
| N | 207V00000X | Obstetrics & Gynecology | 05-39943 | KS | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 5701 W 119th St Ste 225, Overland Park, KS 662093721 | 9136014020 | 9136014022 |
| Street Address |
20 NE SAINT LUKES BLVD STE 310 |
| City | LEES SUMMIT |
| State | MO |
| Zip Code | 64086-6001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669600706 | Courtney Ann Angell | Obstetrics & Gynecology | 20 Ne Saint Lukes Blvd Ste 310, Lees Summit, MO 64086-6001 | 2009-06-28 |
| 1912393109 | Julia C Johnson | Obstetrics & Gynecology | 20 Ne Saint Lukes Blvd Ste 310, Lees Summit, MO 64086 | 2015-04-14 |
| 1770824732 | Susan Ezell | Obstetrics & Gynecology | 20 Ne Saint Lukes Blvd Ste 310, Lees Summit, MO 64086-6001 | 2013-03-14 |
| 1073834271 | Mary A. Cowan | Nurse Practitioner | 20 Ne Saint Lukes Blvd Ste 310, Lees Summit, MO 64086-6001 | 2010-06-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740821057 | David L Harrison | Pharmacist | 6 Nw Sycamore St Ste A, Lees Summit, MO 64086 | 2019-10-08 |
| 1770069403 | Foster Family Pharmacy | Pharmacy | 6 Nw Sycamore St., Suite A, Lee's Summit, MO 64086 | 2018-07-16 |
| 1255716221 | Summit Eye Center, LLC | Ophthalmology | 1621 Nw Blue Parkway, Lees Summit, MO 64086 | 2015-07-20 |
| 1679954085 | Day By Day Staff Relief, LLC | Hospice Care, Community Based | 943 Ne Columbus Street, Lees Summit, MO 64086 | 2015-06-11 |
| 1831505544 | Johnathan Almeida | Emergency Medicine | 100 Ne St Lukes Blvd, Emergency Department, Lees Summit, MO 64086 | 2014-07-02 |
| 1215358429 | Alex Sharifian Dds Summit Modern Dentistry PC | Dentist | 940 Nw Blue Parkway, Suite A, Lee's Summit, MO 64086 | 2013-12-16 |
| 1477807303 | Lauren M Lee | Nurse Practitioner | 1425 Nw Blue Parkway, Lee's Summit, MO 64086 | 2012-10-30 |
| 1396016507 | Retha Rene Rudloff | General Practice | 1728 N.e. Misty Lane, Lee's Summit, MO 64086 | 2012-01-19 |
| 1629351200 | Missouri Dental Professionals, Richard Straus, Dmd, PC | Dentist | 691 Nw Blue Pkwy, Lees Summit, MO 64086 | 2011-09-21 |
| 1497054308 | Jennifer Nelson | Physical Therapist | 301 Ne Tudor, Lee's Summit, MO 64086 | 2011-03-17 |
| Find all providers in zip 64086 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669600706 | Courtney Ann Angell | Obstetrics & Gynecology | 20 Ne Saint Lukes Blvd Ste 310, Lees Summit, MO 64086-6001 | 2009-06-28 |
| 1134225311 | Alexander Gerard Patrick Capelli | Obstetrics & Gynecology | 1000 Sw Blue Pkwy, Lees Summit, MO 64063-2100 | 2006-09-15 |
| 1740241835 | Cynthia Calbert Wallace | Obstetrics & Gynecology | 2000 Se Blue Pkwy, Lees Summit, MO 64063-1041 | 2006-03-29 |
| 1720087232 | Laura Brown Doan | Obstetrics & Gynecology | 3450 Ne Ralph Powell Rd, Lees Summit, MO 64064-2361 | 2005-07-18 |
| 1558364067 | Ingenue Faith Cobbinah | Obstetrics & Gynecology | 2737 Ne Mcbaine Dr, Lees Summit, MO 64064-7880 | 2005-05-30 |
| 1164885422 | Avery Legg | Obstetrics & Gynecology | 3450 Ne Ralph Powell Rd, Lees Summit, MO 64064-2361 | 2016-04-03 |
| 1912393109 | Julia C Johnson | Obstetrics & Gynecology | 20 Ne Saint Lukes Blvd Ste 310, Lees Summit, MO 64086 | 2015-04-14 |
| 1205276680 | Healthcare Exclusively for Women Pa | Obstetrics & Gynecology | 1000 Sw Blue Pkwy, Lees Summit, MO 64063-2100 | 2013-06-28 |
| 1770824732 | Susan Ezell | Obstetrics & Gynecology | 20 Ne Saint Lukes Blvd Ste 310, Lees Summit, MO 64086-6001 | 2013-03-14 |
| 1487917944 | Stephanie Marie Tsai | Obstetrics & Gynecology | 3450 Ne Ralph Powell Rd, Lees Summit, MO 64064-2361 | 2012-06-20 |
| Find all providers in LEES SUMMIT | ||||
| City | LEES SUMMIT |
| Zip Code | 64086 |
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| 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.