NPIMap

Organization Active NPI

Geriatric Primary Care PA

  • Family Medicine Physician
  • Raymore, MO
National Provider Identifier
1073082350
Registry record updated Jul 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
GERIATRIC PRIMARY CARE PA
Practice address
1500 W Foxwood Dr Ste B
Raymore, MO 64083-9372
Phone
(850) 377-0925
Fax
(888) 779-3217
NPI assigned
Nov 16, 2018
Last updated
Jul 1, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2025

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

Authorized official

Name
Mr. Mark Battist, NPNPI 1639681372
Title
Officer
Phone
(850) 377-0925

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

1500 W Foxwood Dr Ste B
Raymore, MO 64083-9372

Mailing address

12120 State Line Rd
PMB 296
Leawood, KS 66209-1254
Phone (850) 377-0925

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181207002149 KS Part B Supplier - Clinic/Group Practice 2466796024 Receives reassigned benefits from 23 practitioners
Practice locations: Overland Park, KS; Leawood, KS; Olathe, KS; Lansing, KS; Lenexa, KS

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
26D2317511Geriatric Primary Care, PA1500 W Foxwood Dr, Suite B, Raymore, MO 64083Certificate of waiverJan 26, 2027

National Provider Directory

National Provider Directory

Locations

13600 W 110th Ter
Lenexa, KS 66215
Phone (913) 717-0071

Practitioners & affiliated clinicians

Practitioners 28

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.

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1542326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751328000000",
    "number": "1073082350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12120 STATE LINE RD",
            "address_2": "PMB 296",
            "city": "LEAWOOD",
            "state": "KS",
            "postal_code": "662091254",
            "telephone_number": "850-377-0925",
            "fax_number": "888-779-3217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 W FOXWOOD DR STE B",
            "city": "RAYMORE",
            "state": "MO",
            "postal_code": "640839372",
            "telephone_number": "850-377-0925",
            "fax_number": "888-779-3217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GERIATRIC PRIMARY CARE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-16",
        "last_updated": "2025-07-01",
        "certification_date": "2025-07-01",
        "status": "A",
        "authorized_official_last_name": "BATTIST",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "850-377-0925",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raymore, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.