Organization Active NPI

MD Electrodiagnosis Inc. P C

  • Neurology Physician
  • Kansas City, MO
National Provider Identifier
1114020617
Registry record updated May 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
MD ELECTRODIAGNOSIS INC. P C
Practice address
2330 E Meyer Blvd Ste T107
Kansas City, MO 64132-1140
Phone
(816) 361-8684
NPI assigned
Sep 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 27, 2024

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

Authorized official

Name
Dr. John J SandNPI 1316904238
Title
President
Phone
(816) 361-8684

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
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X Primary

Addresses

Primary practice location

2330 E Meyer Blvd Ste T107
Kansas City, MO 64132-1140

Mailing address

2330 E Meyer Blvd Ste T107
Kansas City, MO 64132-1140
Phone (816) 361-8684

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061011000745 MO Part B Supplier - Clinic/Group Practice 8527064757 Receives reassigned benefits from 1 practitioner
Practice locations: Kansas City, MO

National Provider Directory

National Provider Directory

Locations

6420 Prospect Ave
Kansas City, MO 64132
Phone (816) 444-2900

6420 Prospect Ave
#T107
Kansas City, MO 64132
Phone (816) 361-8684

2330 E Meyer Blvd
Ste T107
Kansas City, MO 64132
Phone (816) 361-8684

6420 Prospect Ave
Ste T503
Kansas City, MO 64132
Phone (816) 361-8684

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716768000000",
    "number": "1114020617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2330 E MEYER BLVD STE T107",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641321140",
            "telephone_number": "816-361-8684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2330 E MEYER BLVD STE T107",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641321140",
            "telephone_number": "816-361-8684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MD ELECTRODIAGNOSIS INC. P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-07",
        "last_updated": "2024-05-27",
        "certification_date": "2024-05-27",
        "status": "A",
        "authorized_official_last_name": "SAND",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "816-361-8684",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 May 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.