COMMUNITY HOUSE OF WELLNESS (NPI# 1891901054) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891901054 |
| Entity Type | Organization |
| Organization Name | COMMUNITY HOUSE OF WELLNESS |
| Practice Address |
1121 Quindaro Blvd Kansas City KS 66104-5331 |
| Practice Telephone | 9132331733 |
| Practice Fax Number | 9132330055 |
| Mailing Telephone | 9132331733 |
| Mailing Fax Number | 9132330055 |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2010-09-29 |
| Authorized Official Name | DR. MARVIN MCINTOSH (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 9132331733 |
| Authorized Official Credential | MEDICAL DOCTOR |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 0428352 | KS | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KS | 200006440A | 05 | |
| KS | 200006440D | 05 | |
| KS | CHILDREN'S MERCY HEALTH P | 464791 | 01 |
| Street Address |
1121 QUINDARO BLVD |
| City | KANSAS CITY |
| State | KS |
| Zip Code | 66104-5331 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417054362 | Marvin Lynell Mcintosh | Family Medicine | 1121 Quindaro Blvd, Kansas City, KS 66104-5331 | 2006-09-20 |
| 1447400973 | Leslie Gooley | Reflexologist | 1121 Quindaro Blvd, Kansas City, KS 66104-5331 | 2008-09-20 |
| 1720238256 | Universal Life Church Inc. | Reflexologist | 1121 Quindaro Blvd, Kansas City, KS 66104-5331 | 2008-09-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154757078 | Jacob Thomas Brownback | Student in an Organized Health Care Education/Training Program | 4628 Lafayette Ave, Kansas City, KS 66104 | 2013-09-24 |
| 1649238221 | Vishal K Adma | Psychiatry & Neurology | 4300 Brenner Drive, Kansas City, KS 66104 | 2006-05-03 |
| 1629049929 | Josetta Eliese Wahwassuck | Nurse Practitioner | 4300 Brenner Dr, Kvc Prairie Ridge Hospital, Kansas City, KS 66104 | 2006-01-27 |
| 1093191017 | Kvc Hospitals Inc | Psychiatric Hospital | 4300 Brenner Drive, Kansas City, KS 66104 | 2015-07-31 |
| 1578876801 | Sadiq Naveed | Psychiatry & Neurology | 4300 Brenner Dr, Kansas City, KS 66104 | 2010-07-15 |
| 1750397733 | Joyce E Dorssom | Nurse Practitioner | 8919 Parallel Parkway, Suite 555, Kansas City, KS 66104 | 2006-07-31 |
| 1497125470 | Prescription Management Associates | Pharmacy | 4300 Brenner Dr Ste 200, Kansas City, KS 66104-1163 | 2015-10-02 |
| 1205484219 | Sarah Diane Kassin | Nurse Practitioner | 4300 Brenner Dr, Kansas City, KS 66104-1163 | 2019-09-03 |
| 1881197986 | Tricia Lea Felin | Nurse Practitioner | 4300 Brenner Dr, Kansas City, KS 66104-1163 | 2018-03-14 |
| 1639696743 | Jessica Collins Fairchilds | Nurse Practitioner | 4300 Brenner Dr, Kansas City, KS 66104-1163 | 2017-08-29 |
| Find all providers in zip 66104 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356834774 | Lowell Fletcher | Family Medicine | Medical Office Building 2000 Olathe Blvc, Kansas City, KS 66160-0001 | 2018-06-11 |
| 1467943571 | Stopgap | Family Medicine | 202 Admiral Blvd, Kansas City, MO 64106-1504 | 2018-05-24 |
| 1376048876 | Eddy I Ndichie Jr. | Family Medicine | 7900 Lees Summit Rd Fl 3, Kansas City, MO 64139-1236 | 2018-03-27 |
| 1891218541 | Elizabeth Swarna Mukherjee | Family Medicine | 2000 Olathe Blvd, Kansas City, KS 66160 | 2017-07-24 |
| 1639692098 | Partners In Primary Care Nc P C | Family Medicine | 301 E Armour Blvd Ste 2east, Kansas City, MO 64111-1245 | 2017-07-18 |
| 1740719749 | Alejandro Javier Montoya | Family Medicine | 2000 Ne Vivion Rd Ste 100, Kansas City, MO 64118-6127 | 2017-06-05 |
| 1689024382 | Christopher Hazen Short | Family Medicine | 2016 W 43rd Ave Ste A, Kansas City, KS 66103-3313 | 2016-06-14 |
| 1063889905 | Plaza Aesthetics & Wellness LLC | Family Medicine | 4806 Belleview Ave, Kansas City, MO 64112-1321 | 2015-08-26 |
| 1174904544 | Nathan L Boehr | Family Medicine | 5643 Locust St, Kansas City, MO 64110-2735 | 2015-06-11 |
| 1992107585 | Richard Cruz Ibarra | Family Medicine | 754 Pacific Ave, Kansas City, KS 66101-3714 | 2014-09-25 |
| Find all providers in KANSAS CITY | ||||
| City | KANSAS CITY |
| Zip Code | 66104 |
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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.