Active NPI
Michael S Fedotin & B William Ginsberg PA
- Gastroenterology Physician
- Kansas City, MO
National Provider Identifier
1093779605
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- Legal business name
- MICHAEL S FEDOTIN & B WILLIAM GINSBERG PA
- Practice address
- 2330 E Meyer Blvd
Suite 301
Kansas City, MO 64132-1132 - Phone
- (816) 333-5424
- Fax
- (816) 822-0870
- NPI assigned
- Apr 12, 2006
- Last updated
- Apr 23, 2018
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Rita E Fiedler
- Title
- Office Manager
- Phone
- (816) 333-5424
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | NU | Primary |
Addresses
Primary practice location
2330 E Meyer Blvd
Suite 301
Kansas City, MO 64132-1132
Mailing address
2330 E Meyer Blvd
Suite 301
Kansas City, MO 64132-1132
Phone (816) 333-5424
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 509749701 | Medicaid | MO | |
| CP9085 | Other | RR MEDICARE |
National Provider Directory
National Provider DirectoryLocations
6420 Prospect Ave
Ste T407
Kansas City, MO 64132
Phone (816) 333-5424
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.
-
- Adult Health Nurse Practitioner
- Kansas City, MO
- NPI 1245566629
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144800000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1524441600000",
"number": "1093779605",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2330 E MEYER BLVD",
"address_2": "SUITE 301",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "641321132",
"telephone_number": "816-333-5424",
"fax_number": "816-822-0870"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2330 E MEYER BLVD",
"address_2": "SUITE 301",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "641321132",
"telephone_number": "816-333-5424",
"fax_number": "816-822-0870"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MICHAEL S FEDOTIN & B WILLIAM GINSBERG PA",
"organizational_subpart": "NO",
"enumeration_date": "2006-04-12",
"last_updated": "2018-04-23",
"status": "A",
"authorized_official_last_name": "FIEDLER",
"authorized_official_first_name": "RITA",
"authorized_official_middle_name": "E",
"authorized_official_title_or_position": "OFFICE MANAGER",
"authorized_official_telephone_number": "816-333-5424"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "509749701",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "CP9085",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Kansas City, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.