Organization Active NPI

Queen-Morris Ventures L L C

  • Community/Retail Pharmacy
  • Overland Park, KS
National Provider Identifier
1124193701
Registry record updated Dec 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
2-08955 Issued in KS
Legal business name
QUEEN-MORRIS VENTURES L L C
Practice address
8686 Antioch Rd
Overland Park, KS 66212-3648
Phone
(913) 642-4140
Fax
(913) 648-0100
NPI assigned
Nov 21, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Toni Shields, RPH
Title
Director of Pharmacy
Phone
(913) 378-6938

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Practitioners 7

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
17D2168421Queen'S Price Chopper #48686 Antioch Rd, Overland Park, KS 66212Certificate of waiverJun 27, 2027

Medicare participation

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

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20140109001164 KS Part B Supplier - Mass Immunization (Roster Biller Only) 9739380890 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Overland Park, KS; Spring Hill, KS

National Provider Directory

National Provider Directory

Locations

8686 Antioch Rd
#4
Overland Park, KS 66212
Phone (913) 642-4140

22350 S Harrison St
Spring Hill, KS 66083
Phone (913) 592-5350

22350 S Harrison St
#7
Spring Hill, KS 66083
Phone (913) 592-5350

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 2-08955 KS Primary

Addresses

NPPES NPI Registry

Primary practice location

8686 Antioch Rd
Overland Park, KS 66212-3648

Mailing address

8686 Antioch Rd
Overland Park, KS 66212-3648
Phone (913) 642-4140

Other identifiers 3

NPPES NPI Registry
IdentifierTypeStateIssuer
200402260AMedicaidKS
100440080C DMEMedicaidKS
2026150OtherPK

Other names 1

NPPES NPI Registry
  • Queen's Price Chopper #4 Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 2, 2016.

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480636800000",
    "number": "1124193701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8686 ANTIOCH RD",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662123648",
            "telephone_number": "913-642-4140",
            "fax_number": "913-648-0100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8686 ANTIOCH RD",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662123648",
            "telephone_number": "913-642-4140",
            "fax_number": "913-648-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUEEN-MORRIS VENTURES L L C",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-21",
        "last_updated": "2016-12-02",
        "status": "A",
        "authorized_official_last_name": "SHIELDS",
        "authorized_official_first_name": "TONI",
        "authorized_official_title_or_position": "DIRECTOR OF PHARMACY",
        "authorized_official_telephone_number": "913-378-6938",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "KS",
            "license": "2-08955",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200402260A",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100440080C DME",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2026150",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Queen's Price Chopper #4",
            "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 Dec 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.