Active NPI
Empower Preventive Care PA
- Primary Care Clinic/Center
- Overland Park, KS
National Provider Identifier
1124897905
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Clinic/Center
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 17D2303312 | Empower Preventive Care, PA | Certificate of waiver | Apr 22, 2028 |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Internal Medicine Physician
- Overland Park, KS
- NPI 1942263215
KS, Single Specialty
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.