CARONDELET PHYSICIAN SERVICES, INC (NPI# 1982018719) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982018719 |
| Entity Type | Organization |
| Organization Name | CARONDELET PHYSICIAN SERVICES, INC |
| Other Organization Name | CARONDELET FAMILY MEDICAL CARE |
| Practice Address |
930 Carondelet Dr Suite 304 Kansas City MO 64114-4855 |
| Mailing Address |
801 Nw Saint Mary Dr Suite 230 Blue Springs MO 64014-2524 |
| Practice Telephone | 8169437777 |
| Practice Fax Number | 8169437778 |
| Mailing Telephone | 8166555791 |
| Mailing Fax Number | 8166555457 |
| Enumeration Date | 2014-06-19 |
| Last Update Date | 2014-06-19 |
| Authorized Official Name | MR. STEVEN R CLEARY (VP/CFO) |
| Authorized Official Telephone | 8169432819 |
| Is Organization Subpart | Y |
| Parent Organization Name | CARONDELET HEALTH |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 501269500 | 05 | |
| BCBS OF KANSAS CITY | 39532013 | 01 |
| Other Name | Type Code |
|---|---|
| Carondelet Family Medical Care | Doing Business As Name - Organization |
| Street Address |
930 CARONDELET DR SUITE 304 |
| City | KANSAS CITY |
| State | MO |
| Zip Code | 64114-4855 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477556512 | Paula Louise Eaton | Obstetrics & Gynecology | 930 Carondelet Dr, Ste 304, Kansas City, MO 64114-4698 | 2005-05-23 |
| 1588197982 | Alicia M Shuker | Nurse Practitioner | 930 Carondelet Dr, Ste 201, Kansas City, MO 64114 | 2017-04-04 |
| 1669849956 | Omer Leroy | Nurse Practitioner | 930 Carondelet Dr, Ste 201, Kansas City, MO 64114 | 2015-08-21 |
| 1306220447 | Laboratory Corporation of America Holdings | Clinical Medical Laboratory | 930 Carondelet Dr, Kansas City, MO 64114-4855 | 2015-07-18 |
| 1659778264 | Physicians Reference Laboratory LLC | Clinical Medical Laboratory | 930 Carondelet Dr, Bldg C Ste 201, Kansas City, MO 64114-4855 | 2014-11-25 |
| 1881934768 | Lab One LLC | Clinical Medical Laboratory | 930 Carondelet Dr, Suite 200, Kansas City, MO 64114-4855 | 2013-02-28 |
| 1376717181 | Kay Hamilton | Nurse Practitioner | 930 Carondelet Dr, Suite 302, Kansas City, MO 64114-4855 | 2008-04-14 |
| 1497933626 | Norman I Bamber | Neurological Surgery | 930 Carondelet Dr, Suite 300, Kansas City, MO 64114-4855 | 2008-02-11 |
| 1942320767 | Mohsin Quinn Soliman | Surgery | 930 Carondelet Dr, Suite 104, Kansas City, MO 64114-4855 | 2007-03-29 |
| 1801932355 | Overland Pediatrics and Infectious Disease Care LLC | Pediatrics | 930 Carondelet Dr, Suite 303, Kansas City, MO 64114-4855 | 2007-01-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164055968 | Nova Home Infusion, LLC | Home Infusion | 7611 State Line Road, Suite 130 B, Kansas City, MO 64114 | 2020-02-20 |
| 1770011017 | Rene Thomsen | Counselor | 222 W Gregory Blvd Ste 120, Kansas City, MO 64114 | 2017-05-31 |
| 1114452075 | Accent Home Health Care LLC | In Home Supportive Care | 7817 Wornall Rd, Kansas City, MO 64114 | 2017-04-27 |
| 1174982599 | Mei Dodson | Contractor | 8901 Washington St, Kansas City, MO 64114 | 2016-02-12 |
| 1851784805 | Sarah Jeannette Gulledge | Registered Nurse | 930 Carondelet Dr., Suite 201, Kansas City, MO 64114 | 2015-03-16 |
| 1376936591 | Corey Bess | Podiatrist | 1010 Carondelet Dr Ste 301, Kansas City, MO 64114 | 2015-03-12 |
| 1013339753 | Kati Mayer | Physical Therapist | 10008 Walnut Dr., #202, Kansas City, MO 64114 | 2014-01-15 |
| 1619270311 | Gavett Burch | Marriage & Family Therapist | 222 W Gregory Blvd., Suite #319, Kansas City, MO 64114 | 2010-12-18 |
| 1679873046 | Ken Kidd Inc Dba Miracle-ear | Hearing Instrument Specialist | 1148 W. 103rd St, Kansas City, MO 64114 | 2010-11-01 |
| 1316264161 | Elizabeth Vasquez | Physician Assistant | 1004 Carondelet Dr., Suite 330, Kansas City, MO 64114 | 2010-05-03 |
| Find all providers in zip 64114 | ||||
| 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 | 64114 |
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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.