Organization Active NPI

Empower Preventive Care PA

  • Primary Care Clinic/Center
  • Overland Park, KS
National Provider Identifier
1124897905
Registry record updated Dec 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
EMPOWER PREVENTIVE CARE PA
Practice address
5701 W 119TH St Ste 220
Overland Park, KS 66209-3721
Phone
(913) 948-6400
Fax
(913) 948-6499
NPI assigned
Dec 21, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2023

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

Authorized official

Name
Linda A Kelly
Title
Business Manager
Phone
(816) 520-7748

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

5701 W 119TH St Ste 220
Overland Park, KS 66209-3721

Mailing address

5701 W 119TH St Ste 220
Overland Park, KS 66209-3721
Phone (913) 948-6400

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240125000681 KS Part B Supplier - Clinic/Group Practice 6507219623 Receives reassigned benefits from 1 practitioner
Practice locations: Overland Park, KS

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
17D2303312Empower Preventive Care, PA5701 W 119TH St, Ste 220, Overland Park, KS 66209Certificate of waiverApr 22, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1703116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703116800000",
    "number": "1124897905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5701 W 119TH ST STE 220",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662093721",
            "telephone_number": "913-948-6400",
            "fax_number": "913-948-6499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5701 W 119TH ST STE 220",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662093721",
            "telephone_number": "913-948-6400",
            "fax_number": "913-948-6499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMPOWER PREVENTIVE CARE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-21",
        "last_updated": "2023-12-21",
        "certification_date": "2023-12-21",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "816-520-7748"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Dec 21, 2023; 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.