PROVIDENCE MEDICAL GROUP (NPI# 1952947939) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952947939 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE MEDICAL GROUP |
| Practice Address |
8919 Parallel Pkwy Ste 555 Kansas City KS 66112-3628 |
| Practice Telephone | 9135963930 |
| Mailing Telephone | 9135963930 |
| Enumeration Date | 2019-11-25 |
| Last Update Date | 2019-11-26 |
| Authorized Official Name | MS. DIEDRE MCDANIEL (MEDICAL STAFF OFFICE) |
| Authorized Official Telephone | 9135964000 |
| Authorized Official Credential | NA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KS | NPI | 1598741472 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194196832 | Providence Medical Group | General Acute Care Hospital | 1806 Wadsworth Avenue, Bakersfield, CA 93311 | 2015-10-07 |
| 1972533149 | Providence Medical Group | Obstetrics & Gynecology | 2912 Springboro Rd W, Suite 201, Dayton, OH 45439-1674 | 2006-07-04 |
| 1811304595 | Providence Medical Group | Podiatrist | 2912 Springboro Rd, Suite 201, Moraine, OH 45439-1674 | 2014-07-15 |
| 1760658371 | Providence Medical Group | Clinical Medical Laboratory | 2912 Springboro W, Suite 203, Moraine, OH 45439-1674 | 2008-05-03 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | PROVIDENCE MEDICAL GROUP | 105 W 8th Ave Ste 660e, Spokane, WA 99204-2302 |
| Oregon Corporations, Companies and Business Names | PROVIDENCE MEDICAL GROUP | 1801 Lind Ave Sw, Renton, WA 98057 |
| Ohio Business Entities | PROVIDENCE MEDICAL GROUP - THE HEIGHTS | 2912 Springboro West, Suite 201, Dayton, OH 45439 |
| Oregon Corporations, Companies and Business Names | PROVIDENCE MEDICAL GROUP ALASKA | 1801 Lind Ave Sw, Renton, WA 98057 |
| Ohio Business Entities | PROVIDENCE MEDICAL GROUP LABORATORY | 2912 Springboro West, Dayton, OH 45439 |
| Oregon Corporations, Companies and Business Names | PROVIDENCE MEDICAL GROUP MONTANA | 1801 Lind Ave Sw, Renton, WA 98057 |
| Oregon Corporations, Companies and Business Names | PROVIDENCE MEDICAL GROUP NORTHWEST WASHINGTON | 1801 Lind Ave Sw, Renton, WA 98057 |
| Oregon Corporations, Companies and Business Names | PROVIDENCE MEDICAL GROUP SOUTHEAST WASHINGTON | 1801 Lind Ave Sw, Renton, WA 98057 |
| Oregon Corporations, Companies and Business Names | PROVIDENCE MEDICAL GROUP SOUTHWEST WASHINGTON | 1801 Lind Ave Sw, Renton, WA 98057 |
| Street Address |
8919 PARALLEL PKWY STE 555 |
| City | KANSAS CITY |
| State | KS |
| Zip Code | 66112-3628 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083727077 | John N Vani | Orthopaedic Surgery | 8919 Parallel Pkwy Ste 555, Kansas City, KS 66112-3628 | 2006-08-16 |
| 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 | 207XX0005X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Sports Medicine |
| An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton changed, source changed] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. ACGME Accredited Program Requirements: 1 year GME in the specialty + 5 years of Orthopaedic Surgery for a total of 6 years |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306982236 | Kansas University Physicians Inc | Orthopaedic Surgery | G022 Robinson Hall, Mail Stop 3017 3901 Rainbow Blvd, Kansas City, KS 66160 | 2007-01-29 |
| 1306959887 | Dr. Greg J Folsom, An Operating Division of Providence Medical Center | Orthopaedic Surgery | 8919 Parallel Pkwy, Suite 270, Kansas City, KS 66112-1636 | 2006-08-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275056400 | Benedictine College | Orthopaedic Surgery | 1020 N 2nd St Rm 103, Atchison, KS 66002-1402 | 2017-07-19 |
| 1114152121 | Firas I. Kawtharani | Orthopaedic Surgery | 305 W 15th St Ste 101, Liberal, KS 67901 | 2009-05-19 |
| 1932281714 | Christopher Cullen Eckland | Orthopaedic Surgery | 4940 W 137th St Ste B, Leawood, KS 66224-3633 | 2006-10-20 |
| 1972683548 | John G Yost Jr. | Orthopaedic Surgery | 307 N Hospital Dr Ste 3, Girard, KS 66743-2047 | 2006-10-17 |
| 1003809161 | Southeast Kansas Orthopedics & Sports Medicine | Orthopaedic Surgery | 321 East Main, Chanute, KS 66720 | 2005-08-24 |
| 1447872346 | Elite Spine Care of Kansas City, LLC | Orthopaedic Surgery | 4911 W 87th Ter, Prairie Village, KS 66207-2271 | 2020-05-13 |
| 1558881433 | Nathan Daniel Kasting | Orthopaedic Surgery | 400 S Santa Fe Ave, Salina, KS 67401-4144 | 2017-06-22 |
| 1861810137 | Brittany Joie Moore | Orthopaedic Surgery | 10777 Nall Ave Ste 300, Overland Park, KS 66211-1330 | 2014-04-02 |
| 1922358902 | Menorah Medical Group, LLC | Orthopaedic Surgery | 5701 W 119th St, Suite 308, Overland Park, KS 66209-3721 | 2012-09-17 |
| 1558654392 | Michael J Dempewolf | Orthopaedic Surgery | 4940b W. 137th St., Leawood, KS 66224 | 2011-05-26 |
| Find all providers with the same taxonomy | ||||
| City | KANSAS CITY |
| Zip Code | 66112 |
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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.