Organization Active NPI

Optum Clinic, PA

  • Urgent Care Clinic/Center
  • Overland Park, KS
National Provider Identifier
1104250596
Registry record updated Mar 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
OPTUM CLINIC, PA
Practice address
7100 College Blvd
Overland Park, KS 66210-1862
Phone
(913) 905-4700
NPI assigned
Aug 21, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2016

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

Authorized official

Name
Curtis Mock, MD
Title
Ceo
Phone
(401) 732-7325

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

7100 College Blvd
Overland Park, KS 66210-1862

Mailing address

7100 College Blvd
Overland Park, KS 66210-1862
Phone (913) 905-4700

Other names 1

  • Optum Clinic Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1377043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457913600000",
    "number": "1104250596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7100 COLLEGE BLVD",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662101862",
            "telephone_number": "913-905-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7100 COLLEGE BLVD",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662101862",
            "telephone_number": "913-905-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTUM CLINIC, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-21",
        "last_updated": "2016-03-14",
        "status": "A",
        "authorized_official_last_name": "MOCK",
        "authorized_official_first_name": "CURTIS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "401-732-7325",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "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 Mar 14, 2016; 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.