DANE K WICKS (NPI# 1912989138) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912989138 |
| Entity Type | Individual |
| Full Name | DANE K WICKS |
| Credential | MD |
| Practice Address |
4251 Northern Ave Honor Annex Kansas City Va Kansas City MO 64133 |
| Mailing Address |
307 Sw Marion Ln Lees Summit MO 64081-2315 |
| Practice Telephone | 8169222870 |
| Practice Fax Number | 8169224823 |
| Mailing Telephone | 5059775695 |
| Mailing Fax Number | 8166002169 |
| Enumeration Date | 2005-11-15 |
| Last Update Date | 2016-10-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | 84-288 | NM | Allopathic & Osteopathic Physicians |
| Y | 207Q00000X | Family Medicine | R4C66 | MO | Allopathic & Osteopathic Physicians |
| N | 207QG0300X |
Family Medicine Specialization: Geriatric Medicine |
84-288 | NM | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | 34025 | 05 |
| Street Address |
4251 NORTHERN AVE HONOR ANNEX KANSAS CITY VA |
| City | KANSAS CITY |
| State | MO |
| Zip Code | 64133 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568063246 | Veronica Otero Ramos | Psychologist | 4251 Northern Ave, Kansas City, MO 64133-1593 | 2020-11-08 |
| 1053957472 | Avonne Danell Rosario | Nurse Practitioner | 4251 Northern Ave, Kansas City, MO 64133-1593 | 2019-11-20 |
| 1053866541 | Daxten Pruter | Registered Nurse | 4251 Northern Ave, Kansas City, MO 64133-1593 | 2016-08-24 |
| 1760860514 | Michael J. Redd | Marriage & Family Therapist | 4251 Northern Ave, Kansas City, MO 64133-1593 | 2015-05-13 |
| 1669859898 | Jeana Urania Smith | Social Worker | 4251 Northern Ave, Kansas City, MO 64133-1593 | 2015-04-27 |
| 1629486287 | Amber Hinton-dampf | Psychologist | 4251 Northern Ave, Kansas City, MO 64133-1593 | 2014-07-28 |
| 1215981980 | Savitri Manda | Family Medicine | 4251 Northern Ave, Kansas City, MO 64133-1593 | 2006-05-19 |
| 1235194705 | Sudhir Hegde | Internal Medicine | 4251 Northern Ave, Kansas City, MO 64133-1593 | 2006-04-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376029652 | Lauren Chapman Bauer | Occupational Therapy Assistant | 9540 E 75th Street, Raytown, MO 64133 | 2018-07-19 |
| 1871946160 | Brent Jordan Miller | Nurse Practitioner | 9400 East 350 Highway, Raytown, MO 64133 | 2016-07-21 |
| 1518355957 | Sheeba Fazili | Counselor | 8801 East, 63 Rd Street, Raytown, Suite 101, Missouri, KS 64133 | 2015-01-08 |
| 1770998676 | Diana Garcia | Speech-Language Pathologist | 11812 E. 61st. Street, Kansas City, MO 64133 | 2014-06-30 |
| 1326489642 | Helping Hands Adult Day Center | Clinic/Center | 6610 Blue Ridge Blvd., Kansas City, MO 64133 | 2013-07-15 |
| 1346687936 | Judith Hope Evans | Pharmacist | 300 Blue Parkway, Lees Summit, MO 64133 | 2013-05-23 |
| 1912249855 | Shanna O'brien | Social Worker | 8801 E 63rd St Ste 101, Raytown, MO 64133 | 2013-03-18 |
| 1013266550 | Lauren Sword | Chiropractor | 9537 E 57th Terr, Raytown, MO 64133 | 2012-08-30 |
| 1528339207 | Olivia Luelf | Speech-Language Pathologist | 6608 Raytown Rd., Raytown, MO 64133 | 2012-01-26 |
| 1356639074 | Michelle Paulette Cruickshank | Massage Therapist | 6522 Sterling Ave, Raytown, MO 64133 | 2011-07-15 |
| Find all providers in zip 64133 | ||||
| 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 | 64133 |
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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.