Individual provider Active NPI

Suntukung Jarjou

  • Registered Nurse
  • Kansas City, KS
National Provider Identifier
1114757234
Registry record updated Aug 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
107166 Issued in KS
Practice address
1936 N 5TH St
Kansas City, KS 66101-1705
Phone
(913) 832-9830
NPI assigned
Aug 5, 2024
Last updated
Aug 5, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 107166 KS Primary

Addresses

Primary practice location

1936 N 5TH St
Kansas City, KS 66101-1705

Mailing address

1301 Oak St Ste 608
Kansas City, MO 64106-2865
Phone (913) 232-7506

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
107166KSMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
A & S Home Medical Supply LLC CurrentSince Sep 23, 2024 Accepting new patients

Locations

1936 N 5th St
Kansas City, KS 66101
Phone (816) 427-2871

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1722816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722816000000",
    "number": "1114757234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 OAK ST STE 608",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641062865",
            "telephone_number": "913-232-7506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1936 N 5TH ST",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661011705",
            "telephone_number": "913-832-9830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARJOU",
        "first_name": "SUNTUKUNG",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-08-05",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KS",
            "license": "107166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2024; 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.