NPIMap

Organization Active NPI

Medbasics Missouri LLC

  • Primary Care Clinic/Center
  • Independence, MO
National Provider Identifier
1063698827
Registry record updated Jan 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
MEDBASICS MISSOURI LLC
Practice address
4201 S Noland Rd
Independence, MO 64055-7313
Phone
(816) 373-9901
Fax
(816) 373-9905
NPI assigned
Jan 10, 2008
Last updated
Jan 10, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
MEDBASICS INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 10, 2008

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

Authorized official

Name
Jodi Krusely
Title
Account Manager
Phone
(847) 838-3832

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

4201 S Noland Rd
Independence, MO 64055-7313

Mailing address

PO Box 671621
Dallas, TX 75267-1621
Phone (972) 580-7700

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1199923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199923200000",
    "number": "1063698827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 671621",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752671621",
            "telephone_number": "972-580-7700",
            "fax_number": "972-580-7715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 S NOLAND RD",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640557313",
            "telephone_number": "816-373-9901",
            "fax_number": "816-373-9905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDBASICS MISSOURI LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDBASICS INC",
        "enumeration_date": "2008-01-10",
        "last_updated": "2008-01-10",
        "status": "A",
        "authorized_official_last_name": "KRUSELY",
        "authorized_official_first_name": "JODI",
        "authorized_official_title_or_position": "ACCOUNT MANAGER",
        "authorized_official_telephone_number": "847-838-3832"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Independence, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2008; 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.