NPIMap

Organization Active NPI

Mid-America Polyclinic PA

  • Physical Medicine & Rehabilitation Physician
  • Overland Park, KS
National Provider Identifier
1124087861
Registry record updated Feb 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
MID-AMERICA POLYCLINIC PA
Practice address
7100 College Blvd
Overland Park, KS 66210
Phone
(913) 599-2440
Fax
(913) 599-5252
NPI assigned
Mar 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2019

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

Authorized official

Name
Srinivas Nalamachu, MD
Title
President
Phone
(913) 599-2440

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X Primary

Addresses

Primary practice location

7100 College Blvd
Overland Park, KS 66210

Mailing address

7100 College Blvd
Overland Park, KS 66210
Phone (913) 599-2440

Other identifiers 1

IdentifierTypeStateIssuer
21532015OtherMOBLUE SHIELD KANSAS CITY

National Provider Directory

National Provider Directory

Locations

11120 Tomahawk Creek Pkwy
Leawood, KS 66211
Phone (913) 559-2440

7100 College Blvd
Overland Park, KS 66210
Phone (913) 599-2440

8675 College Blvd
Ste 150
Overland Park, KS 66210
Phone (913) 338-1356

7100 College Blvd
Ste 1
Overland Park, KS 66210

Practitioners & affiliated clinicians

Practitioners 10

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": "1142899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549843200000",
    "number": "1124087861",
    "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": "66210",
            "telephone_number": "913-599-2440",
            "fax_number": "913-599-5252"
        },
        {
            "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": "66210",
            "telephone_number": "913-599-2440",
            "fax_number": "913-599-5252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-AMERICA POLYCLINIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-21",
        "last_updated": "2019-02-11",
        "status": "A",
        "authorized_official_last_name": "NALAMACHU",
        "authorized_official_first_name": "SRINIVAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "913-599-2440",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD KANSAS CITY",
            "identifier": "21532015",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Feb 11, 2019; 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.