Lee's Summit Dermatology Associates I, PC

Primary specialty

SpecialistTaxonomy code 174400000X

License

R9N60 Issued in MO

Legal business name

LEE'S SUMMIT DERMATOLOGY ASSOCIATES I, PC

Practice address

276 NE Tudor Rd
Lee's Summit, MO 64086-5696

Phone

(816) 525-8500

Fax

(816) 525-0185

NPI assigned

Jan 29, 2007

Last updated

Aug 22, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Gary W McEwen, M.D.NPI 1477554657

Title

Owner

Phone

(816) 525-8500

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Gary W McEwen, M.D.

  • Dermatology Physician
  • Lee's Summit, MO
  • NPI 1477554657
  Medicare reassignment Care Compare group NPD Authorized official
• Matthew Wayne McEwen, MD

  • Dermatology Physician
  • Lee's Summit, MO
  • NPI 1730686643
  Medicare reassignment Care Compare group NPD
• Amber Joy Kunshek, NP

  • Nurse Practitioner
  • Lee's Summit, MO
  • NPI 1861508871
  Medicare reassignment Care Compare group
• Linh T Nguyen, PA-C

  • Physician Assistant
  • Lee's Summit, MO
  • NPI 1619303658
  Medicare reassignment Care Compare group
• Kelly Michele Czarnecki, PAC

  • Physician Assistant
  • Flagstaff, AZ
  • NPI 1043234610
  NPD (past)

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219363200000",
    "number": "1205972270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "276 NE TUDOR RD",
            "city": "LEE'S SUMMIT",
            "state": "MO",
            "postal_code": "640865696",
            "telephone_number": "816-525-8500",
            "fax_number": "816-525-0185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "276 NE TUDOR RD",
            "city": "LEE'S SUMMIT",
            "state": "MO",
            "postal_code": "640865696",
            "telephone_number": "816-525-8500",
            "fax_number": "816-525-0185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEE'S SUMMIT DERMATOLOGY ASSOCIATES I, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-29",
        "last_updated": "2008-08-22",
        "status": "A",
        "authorized_official_last_name": "MCEWEN",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "816-525-8500",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MO",
            "license": "R9N60",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Malon N Lee, PLPC
• Shelby Lee
• Shelby Lee, PT, DPT
• Lee's Summit Chiropractic Center P.C.
• Lee's Summit Chiropractic Group
• Lee's Summit Family Care LLC
• Lee's Summit Physicians Group - Internal Medicine LLC
• Lee's Summit Physicians Group Urgent Care
• Lee's Summit R-7 School District
• Lee's Summit School District R-7

• Specialist in Lee's Summit, MO
• Providers in Lee's Summit, MO by specialty
• Specialist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2008; 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.