MR. PAUL BENNETT BROCK JR. (NPI# 1811384373) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811384373 |
| Entity Type | Individual |
| Full Name | MR. PAUL BENNETT BROCK JR. |
| Practice Address |
4320 Wornall Rd Ste 530 Kansas City MO 64111-5942 |
| Mailing Address |
901 E 104th St Kansas City MO 64131-4517 |
| Practice Telephone | 8169322836 |
| Practice Fax Number | 8169329868 |
| Mailing Telephone | 8165999499 |
| Mailing Fax Number | 8169329670 |
| Enumeration Date | 2015-04-22 |
| Last Update Date | 2020-09-15 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208600000X | Surgery | 04-43521 | KS | Allopathic & Osteopathic Physicians |
| Y | 208600000X | Surgery | 2020024439 | MO | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467731695 | Paul Talmage Brock II | Nurse Anesthetist, Certified Registered | 2100 Erwin Road, Durham, NC 27705-3941 | 2011-08-05 |
| 1235275322 | Paul L Brock | Pharmacist | 12401 E Marginal Way S, Tukwila, WA 98168-2558 | 2007-01-29 |
| 1790845048 | Paul Bennett Brock | Surgery | 1825 Martha Berry Blvd Nw, Rome, GA 30165-1625 | 2006-12-09 |
| 1437242328 | Paul Arthur Brock | Chiropractor | 14151 Newport Ave Ste 102, Tustin, CA 92780-5174 | 2006-10-02 |
| 1457351876 | Paul W. Brock | Anesthesiology | 6720 Bertner St, Suite O-520, Houston, TX 77030-2604 | 2005-07-28 |
| Street Address |
4320 WORNALL RD STE 530 |
| City | KANSAS CITY |
| State | MO |
| Zip Code | 64111-5942 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326074006 | Sean Allen Nix | Surgery | 4320 Wornall Rd Ste 530, Kansas City, MO 64111-5942 | 2006-06-24 |
| 1386276434 | Abigayle Rose Mcgrew | Physician Assistant | 4320 Wornall Rd Ste 530, Kansas City, MO 64111-5942 | 2020-02-06 |
| 1417315839 | Marci Cunningham | Physician Assistant | 4320 Wornall Rd Ste 530, Kansas City, MO 64111-5942 | 2016-01-30 |
| 1104203058 | Stephanie Elaine Bollenbach | Surgery | 4320 Wornall Rd Ste 530, Kansas City, MO 64111-5942 | 2015-04-29 |
| 1700204559 | Barbara Nguyen | Surgery | 4320 Wornall Rd Ste 530, Kansas City, MO 64111-5942 | 2014-03-30 |
| 1417247800 | Robert Amajoyi | Colon & Rectal Surgery | 4320 Wornall Rd Ste 530, Kansas City, MO 64111-5942 | 2011-04-19 |
| 1568773372 | Thuan Nguyen | Plastic Surgery | 4320 Wornall Rd Ste 530, Kansas City, MO 64111-5942 | 2010-06-25 |
| 1306072459 | Julie Lynn Porter | Nurse Practitioner | 4320 Wornall Rd Ste 530, Kansas City, MO 64111-5942 | 2009-06-03 |
| 1457504722 | Leo Andrew Osifuye Benedict | Surgery | 4320 Wornall Rd Ste 530, Kansas City, MO 64111 | 2008-10-29 |
| 1215019518 | Theresa Elizabeth Robertson | Surgery | 4320 Wornall Rd Ste 530, Kansas City, MO 64111-5942 | 2006-10-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184242810 | Kristen Casey | Psychologist | 4050 Pennsylvania Ave Ste 115, Pmb 2746, Kansas City, MO 64111 | 2020-07-09 |
| 1336765015 | Tyler Hoelting | Chiropractor | 3611 Main Street, Kansas City, MO 64111 | 2020-06-18 |
| 1003452764 | Sarah Anne Heavey | Nurse Practitioner | 4300 Wornall Road, Ste 2000, Kansas City, MO 64111 | 2019-11-18 |
| 1558844241 | Guardian Angels, LLC | Home Health | 4049 Pennsylvania Ave, Kansas City, MO 64111 | 2018-09-10 |
| 1730669169 | Hannah Eagleburger | Physician Assistant | 4321 Wornall Rd, Ste 530, Kansas City, MO 64111 | 2018-08-15 |
| 1316460835 | Kandace Callwell | Counselor | 4106 Baltimore Ave, Kansas City, MO 64111 | 2017-07-18 |
| 1780046250 | Sara Koenemann | Nurse Practitioner | 4400 Broadway St., Ste. 520, Kansas City, MO 64111 | 2016-03-24 |
| 1932586245 | Suzzette Griffith | Acupuncturist | 406 W 34th Street Ste 812, Kansas City, MO 64111 | 2015-05-06 |
| 1972999225 | Timothy O Olatunde | Emergency Medicine | 4410 Wornall Road, Kansas City, MO 64111 | 2015-04-14 |
| 1730595026 | Morgan Nelson | Audiologist | 4230 Wornall Road, Suite 420, Kansas City, MO 64111 | 2014-07-07 |
| Find all providers in zip 64111 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851886949 | Adam Kahle | Surgery | 4000 Cambridge, Department of Surgery, M/s 2005, Kansas City, KS 66160 | 2018-06-29 |
| 1184910028 | Elizabeth Catherine Butler | Surgery | 5820 Nw Barry Rd Ste 300, Kansas City, MO 64154-2578 | 2011-06-20 |
| 1629256235 | Saint Luke's Hospital Physician Billing Services, LLC | Surgery | 4323 Wornall Road, Peet Center Level 3, Kansas City, MO 64111 | 2008-02-06 |
| 1326259623 | Joshua Matthew Varghise Mammen | Surgery | 3901 Rainbow Blvd 4000 Murphy, University of Kansas Medical Center, Department of Surg, Kansas City, KS 66103-2937 | 2007-05-25 |
| 1033141635 | Karthik Vamanan | Surgery | 4320 Wornall Rd Ste 50, Kansas City, MO 64111-5943 | 2006-07-06 |
| 1437185543 | Robert J Kenney Jr. | Surgery | 5844 Nw Barry Rd Ste 120, Kansas City, MO 64154-1483 | 2006-06-23 |
| 1912951518 | Surgical Consultants of Kansas City, P C | Surgery | 1010 Carondelet Dr Ste 114, Kansas City, MO 64114-4821 | 2006-05-19 |
| 1780243741 | Brian Cummiskey | Surgery | 3901 Rainbow Blvd, Kansas City, KS 66160-8500 | 2019-06-12 |
| 1922663988 | Gabrielle Rico | Surgery | 1750 Independence Ave, Kansas City, MO 64106-1453 | 2019-05-06 |
| 1376004945 | Derek Ryan Marlor | Surgery | 3901 Rainbow Blvd, Kansas City, KS 66160-8500 | 2019-03-27 |
| Find all providers in KANSAS CITY | ||||
| City | KANSAS CITY |
| Zip Code | 64111 |
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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.