Advanced Orthopedics and Sports Medicine
Organization Active NPI Orthopaedic Surgery Physician · Lees Summit, MO
NPI 1003268087 · NPPES record last updated Oct 20, 2023
Key facts
- NPI
- 1003268087
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Orthopaedic Surgery Physician 207X00000X
- Legal business name
- ADVANCED ORTHOPEDICS AND SPORTS MEDICINE
- Practice address
- 2861 NE Independence Ave Ste 201
Lees Summit, MO 64064-2379 - Phone
- (816) 525-2840
- Fax
- (816) 525-2841
- NPI assigned
- Jul 1, 2016
- Organization subpart
- No
Authorized official
- Name
- Matthew Daggett
- Title
- VP of Operations
- Phone
- (816) 525-2840
Member organizations 2
Practitioners 63
-
Danny K Carroll, M.D.
-
Matthew Thomas Cullen, D.O.
-
Matthew C. Daggett, D.O.
-
Nicole Fremarek, DO, MBA
-
Georgiana Sue Gonzalez, FNP-BC
-
Jessica Grace Kretchmar, MSN, APRN, FNP-C
-
Kayel Newland, PA-C
-
Timothy P Roberts, D.O.
-
Chloe Elizabeth Stephens, FNP-C
-
John Swab, D.O.
-
Kevin Andrew Witte, D.O.
-
Elliott Wityk, DPM
-
Dustin S Woyski, D.O.
-
Luke Allen Byerly, M.D.
-
Brian Joseph Callahan, MSN, APRN, FNP-C
-
Michael J Dempewolf, D.O.
-
Daniel C Farrell, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (3 enrollments) in MO, KS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170113002161 | MO | Part B Supplier - Clinic/Group Practice | 8820370422 |
Receives reassigned benefits from 59 practitioners Practice locations: Kansas City, MO; Lees Summit, MO; Raymore, MO |
| O20170817002249 | KS | Part B Supplier - Clinic/Group Practice | 8820370422 |
Receives reassigned benefits from 55 practitioners Practice locations: Overland Park, KS; Paola, KS |
| O20190507002425 | MO | DME Supplier - Physician - Orthopedic/Orthopedic Surgery | 8820370422 | Practice locations: Lees Summit, MO |
National Provider Directory
Locations
11340 Nall Ave
Ste 200
Overland Park, KS 66211
Phone (913) 354-5020
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician |
207X00000X | Yes |
Addresses
Primary practice location
2861 NE Independence Ave Ste 201
Lees Summit, MO 64064-2379
Mailing address
2861 NE Independence Ave Ste 201
Lees Summit, MO 64064-2379
Phone (816) 525-2840
Other practice location 1
11340 Nall Ave, Suite 200
Overland Park, KS 66211
Phone (816) 525-2840
Other practice location 2
7201 E 147th St Ste 120
Grandview, MO 64030-4204
Phone (816) 525-2840
Other practice location 3
505 S Hospital Dr
Paola, KS 66071-1850
Phone (816) 525-2840
Other names
- Sano Orthopedics
Other providers in Lees Summit, MO
- Sainy Adel
- Ahmed Ali Adow
- Advanced Dental of Lees Summit LLC
- Advanced Foot Care Center, PC
- Advanced Health Care, LLC
- Advanced PT LLC
- Advanced Surgical Associates
- Mojan Afzali
- Ag Counseling LLC
- Agape in Home & Health Care, LLC
All providers in Lees Summit, MO · Orthopaedic Surgery Physician in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 20, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.