NPIMap

Organization Active NPI

Optum Medical Services, PC

Doing business as Optum Clinic

  • Family Medicine Physician
  • Overland Park, KS
National Provider Identifier
1053721779
Registry record updated May 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
OPTUM MEDICAL SERVICES, PC
Doing business as
Optum Clinic
Practice address
6860 W 115TH St
Overland Park International Trade
Overland Park, KS 66211-2457
Phone
(800) 645-9656
NPI assigned
May 2, 2014
Last updated
May 2, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Ronald Shumacher, MDNPI 1447593736
Title
Owner
Phone
(240) 683-5331

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

6860 W 115TH St
Overland Park International Trade
Overland Park, KS 66211-2457

Mailing address

PO Box 692
Minneapolis, MN 55440-0692
Phone (800) 645-9656

Other names 1

  • Optum Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Optum Medical Services PC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1398988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398988800000",
    "number": "1053721779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 692",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554400692",
            "telephone_number": "800-645-9656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6860 W 115TH ST",
            "address_2": "OVERLAND PARK INTERNATIONAL TRADE",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662112457",
            "telephone_number": "800-645-9656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTUM MEDICAL SERVICES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-02",
        "last_updated": "2014-05-02",
        "status": "A",
        "authorized_official_last_name": "SHUMACHER",
        "authorized_official_first_name": "RONALD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "240-683-5331",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Optum Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Overland Park, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.