Organization Active NPI

Michael S Fedotin & B William Ginsberg PA

  • Gastroenterology Physician
  • Kansas City, MO
National Provider Identifier
1093779605
Registry record updated Apr 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
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, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2018

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
509749701MedicaidMO
CP9085OtherRR MEDICARE

National Provider Directory

National Provider Directory

Locations

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.

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.

Verify at the official NPI Registry.