Active NPI
KC Childrens Surgery Center LLC
- Ambulatory Surgical Clinic/Center
- Kansas City, KS
National Provider Identifier
1124522495
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulatory Surgical Clinic/Center
- Legal business name
- KC CHILDRENS SURGERY CENTER LLC
- Practice address
- 7848 State Ave
Kansas City, KS 66112-2417 - Phone
- (717) 759-4378
- NPI assigned
- Mar 21, 2018
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Devin Larsen
- Title
- Ceo
- Phone
- (208) 340-1840
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Surgical Clinic/Center | 261QA1903X | Primary |
Addresses
Primary practice location
7848 State Ave
Kansas City, KS 66112-2417
Mailing address
9709 Lakeside Blvd Ste 350
Spring, TX 77381-1213
Phone (713) 489-2198
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KS
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20180419001273 | KS | Part B Supplier - Ambulatory Surgical Center | 8325301690 | Practice locations: Kansas City, KS |
Ambulatory surgical center certification: CCN 17C0001096
Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.
- Legal name
- KC CHILDRENS SURGERY CENTER, LLC
- Certification status
- Active
- Provider type (POS)
- Ambulatory surgical center
- Participating since
- Jun 4, 2019
- Last certification
- Jun 4, 2019
- Ownership / control type
- Proprietary
- Facility address
- 7848 State Ave
Kansas City, KS 66112
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1521590400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1737936000000",
"number": "1124522495",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9709 LAKESIDE BLVD STE 350",
"city": "SPRING",
"state": "TX",
"postal_code": "773811213",
"telephone_number": "713-489-2198",
"fax_number": "713-489-2978"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7848 STATE AVE",
"city": "KANSAS CITY",
"state": "KS",
"postal_code": "661122417",
"telephone_number": "717-759-4378"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "KC CHILDRENS SURGERY CENTER LLC",
"organizational_subpart": "NO",
"enumeration_date": "2018-03-21",
"last_updated": "2025-01-27",
"certification_date": "2025-01-27",
"status": "A",
"authorized_official_last_name": "LARSEN",
"authorized_official_first_name": "DEVIN",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "208-340-1840"
},
"taxonomies": [
{
"code": "261QA1903X",
"taxonomy_group": "",
"desc": "Clinic/Center, Ambulatory Surgical",
"state": null,
"license": null,
"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 Jan 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.