Independence Surgical Clinic, Inc.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

105155 Issued in MO

Legal business name

INDEPENDENCE SURGICAL CLINIC, INC.

Practice address

19550 East 39TH Street S
Suite 325
Independence, MO 64057-2310

Phone

(816) 373-4646

Fax

(816) 373-7831

NPI assigned

Mar 27, 2007

Organization subpart

No

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

Authorized official

Name

Mindi Suzanne Thompson Beahm, MDNPI 1669663571

Title

President

Phone

(816) 373-4646

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/6816

Practitioners 5

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

• Mindi Suzanne Thompson Beahm, MD

  • Surgery Physician
  • Independence, MO
  • NPI 1669663571
  Medicare reassignment Care Compare group Authorized official
• Jared B Smith, MD

  • Surgery Physician
  • Independence, MO
  • NPI 1710033493
  Medicare reassignment Care Compare group
• John Christopher Lewandowski

  • Surgery Physician
  • Independence, MO
  • NPI 1053773879
  Medicare reassignment
• Howard L Kremer, M.D.

  • Surgery Physician
  • Kansas City, MO
  • NPI 1801858386
  NPD (past)
• Thomas Jenry Safley III, M.D.

  • Surgery Physician
  • Independence, MO
  • NPI 1346293230
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720569600000",
    "number": "1144348012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19550 EAST 39TH STREET S",
            "address_2": "SUITE 325",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640572310",
            "telephone_number": "816-373-4646",
            "fax_number": "816-373-7831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19550 EAST 39TH STREET S",
            "address_2": "SUITE 325",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640572310",
            "telephone_number": "816-373-4646",
            "fax_number": "816-373-7831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPENDENCE SURGICAL CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-27",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A",
        "authorized_official_last_name": "BEAHM",
        "authorized_official_first_name": "MINDI",
        "authorized_official_middle_name": "SUZANNE THOMPSON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "816-373-4646",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "MO",
            "license": "105155",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "00486013",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200395002",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Independence Pediatrics PC
• Independence Pediatrics, P.C. Inc.
• Independence Regional Medical Group LLC
• Independence School District
• Independence School District
• Independence Women'S Clinic
• Independence Womens Clinic PC
• Hannah Marie Ingram, DDS
• Trinity J Ingram, PLPC
• Innovative Infusions, LLC

• Surgery Physician in Independence, MO
• Providers in Independence, MO by specialty
• Surgery Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.