INDEPENDENCE PEDIATRICS, P.C. INC. (NPI# 1962532283) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962532283 |
| Entity Type | Organization |
| Organization Name | INDEPENDENCE PEDIATRICS, P.C. INC. |
| Practice Address |
17500 Medical Center Pkwy Suite 5 Independence MO 64057-1823 |
| Practice Telephone | 8163731111 |
| Practice Fax Number | 8163739222 |
| Mailing Telephone | 8163731111 |
| Mailing Fax Number | 8163739222 |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. WELDON LEE HARRIS (PRIMARY CARE PHYSICIAN) |
| Authorized Official Telephone | 8163731111 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 35496 | MO | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | J619948 | 05 | |
| MO | J61A008 | 05 |
| Street Address |
17500 MEDICAL CENTER PKWY SUITE 5 |
| City | INDEPENDENCE |
| State | MO |
| Zip Code | 64057-1823 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285681460 | Sheela Ananth | Pediatrics | 17500 Medical Center Pkwy, Suite 5, Independence, MO 64057-1823 | 2006-05-31 |
| 1992964845 | Independence Pediatrics PC | Clinic/Center | 17500 Medical Center Pkwy, Suite 5, Independence, MO 64057 | 2008-06-05 |
| 1225146962 | Robert Norman Hanson | Dentist | 17500 Medical Center Pkwy, Suite #1, Independence, MO 64057-1823 | 2006-08-25 |
| 1073621645 | Robert N. Hanson D.d.s., P.C. | Dentist | 17500 Medical Center Pkwy, Suite #1, Independence, MO 64057-1823 | 2006-08-25 |
| 1639108715 | Jerald E Elrod I | Dentist | 17500 Medical Center Pkwy, Suite 2, Independence, MO 64057-1823 | 2006-07-01 |
| 1548201106 | Weldon Harris | Pediatrics | 17500 Medical Center Pkwy, Suite 5, Independence, MO 64057-1823 | 2006-06-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174002364 | Justine Barye Bolton | Physical Therapist | 2301 South 291 Highway, Independence, MO 64057 | 2018-08-09 |
| 1194230136 | Brantley Vincent Niendick | Occupational Therapist | 2301 S M 291 Hwy, Independence, MO 64057 | 2017-12-13 |
| 1437693561 | Derek Faulkner | Counselor | 2400 Little Blue Pkwy, Independence, MO 64057 | 2016-12-08 |
| 1578916136 | Jared Donald Gerstenkorn | Physical Therapist | 2301 South Highway 291, Independence, MO 64057 | 2016-07-19 |
| 1295198182 | Jennifer J Allen | Nurse Practitioner | 2310 Castle Drive, Independence, MO 64057 | 2016-03-30 |
| 1750750808 | Lisa Louise Freeman | Physical Therapy Assistant | 3980 S Jackson Dr, Independence, MO 64057 | 2015-09-18 |
| 1437543592 | Harold Epps | Specialist/Technologist | 2301 South Mo 291 Highway, Independence, MO 64057 | 2015-03-26 |
| 1245620426 | Holly Morgan | Occupational Therapist | 3980 S Jackson Dr., Independence, MO 64057 | 2015-01-27 |
| 1093128159 | Jennifer Falk Crumbaugh | Dentist | 3151 S. M-291 Highway, Suite A, Independence Mo, MO 64057 | 2014-06-06 |
| 1952711954 | Judy Bray | Occupational Therapy Assistant | 3980 East Jackson Drive, Independence, MO 64057 | 2014-04-30 |
| Find all providers in zip 64057 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265892905 | Debra Moravac | Specialist | 17313 E 54th Ter Ct, Independence, MO 64055-7832 | 2016-02-23 |
| 1295165017 | Tracy Lynn Gastright | Specialist | 6264 Martys Trl, Independence, KY 41051-8377 | 2013-11-14 |
| 1548541782 | The Outlet Place for Women | Specialist | 1308 W Truman Rd, Independence, MO 64050-3433 | 2011-09-01 |
| 1669777215 | Jayme Anne Richerson | Specialist | 4202 Briarwood Dr, Independence, KY 41051-9512 | 2011-01-12 |
| 1609177864 | Charles R Genovese Jr Md Inc | Specialist | 312 E Rail Road Ave, Independence, LA 70443 | 2010-11-04 |
| 1609006329 | Gary Joseph Do, Inc. | Specialist | 4700 Rockside Rd, Suite 535, Independence, OH 44131-2155 | 2009-07-15 |
| 1073758983 | Carrie Robin Chadwick | Specialist | 10933 Griststone Cir, Independence, KY 41051-7596 | 2008-12-05 |
| 1255522009 | Midwest Neuroscience PC | Specialist | 17020 E 40 Hwy, Suite 8, Independence, MO 64055-5365 | 2007-08-07 |
| 1336355064 | Virendra C. Patel | Specialist | 921 W Myrtle St, Independence, KS 67301-3241 | 2007-05-16 |
| 1891900304 | Milo Marvin Farnham | Specialist | 14505 E 32nd Ter S, Independence, MO 64055-2512 | 2007-05-10 |
| Find all providers in INDEPENDENCE | ||||
| City | INDEPENDENCE |
| Zip Code | 64057 |
Please comment or provide details below to improve the information on INDEPENDENCE PEDIATRICS, P.C. INC..
| 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.