Jawaria Shoaib Chatta, MD

Individual provider Active NPI Family Medicine Physician · Grandview, MO

NPI 1124866397 · NPPES record last updated Jul 19, 2024

Key facts

NPI
1124866397
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
2024018106 (MO)
Practice address
13013 Fuller Ave Ste a
Grandview, MO 64030-2687
Phone
(816) 214-5548
NPI assigned
Jul 19, 2024
Sex
Female
Sole proprietor
No

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 and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2024018106MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Medina Clinic, Incorporated Past
since Jul 21, 2024
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2024018106 MO Yes

Addresses

Primary practice location

13013 Fuller Ave Ste a
Grandview, MO 64030-2687

Mailing address

4802 W 147TH St
Leawood, KS 66224-7804
Phone (913) 370-6837

Other providers in Grandview, MO

All providers in Grandview, MO · Family Medicine Physician in Missouri

Sources for this page

Verify at the official NPI Registry.