Organization Active NPI

Obstetrics and Pediatrics Subspecialty Group of Kansas and Missouri PA

  • Maternal & Fetal Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1225051618
Registry record updated Oct 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X
Legal business name
OBSTETRICS AND PEDIATRICS SUBSPECIALTY GROUP OF KANSAS AND MISSOURI PA
Practice address
4722 N 24TH St Ste 150
Phoenix, AZ 85016-4860
Phone
(877) 885-0588
NPI assigned
Jul 26, 2006
Last updated
Oct 23, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2024

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

Authorized official

Name
Dr. Michael D Dwyer
Title
Assistant Secretary
Phone
(954) 384-0175

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Maternal & Fetal Medicine Physician 207VM0101X Primary
Pediatrics Physician 208000000X
Developmental - Behavioral Pediatrics Physician 2080P0006X
Pediatric Cardiology Physician 2080P0202X
Pediatric Critical Care Medicine Physician 2080P0203X
Pediatric Gastroenterology Physician 2080P0206X
Pediatric Infectious Diseases Physician 2080P0208X
Pediatric Surgery Physician 2086S0120X
Pediatric Orthopaedic Surgery Physician 207XP3100X

Addresses

Primary practice location

4722 N 24TH St Ste 150
Phoenix, AZ 85016-4860

Mailing address

1301 Concord Ter
Sunrise, FL 33323-2843
Phone (800) 243-3839

Other identifiers 3

IdentifierTypeStateIssuer
100309390AMedicaidKS
100309390BMedicaidKS
162830002MedicaidAR

National Provider Directory

National Provider Directory

Locations

3510 Clinton Pkwy
Ste 310
Lawrence, KS 66047
Phone (785) 830-8105

3510 Clinton Pl
Lawrence, KS 66047
Phone (785) 840-3780

3510 Clinton Pl
Ste 310
Lawrence, KS 66047
Phone (785) 841-0326

12200 W 106th St
Ste 110
Overland Park, KS 66215

19550 E 39th St S
Ste 335B
Independence, MO 64057
Phone (816) 350-2024

4400 Wornall Rd
Fl 2
Kansas City, MO 64111

4401 Wornall Rd
Fl 1
Kansas City, MO 64111
Phone (816) 932-3585

4401 Wornall Rd
Fl Opc
Kansas City, MO 64111

301 NE Mulberry St
Ste 202
Lees Summit, MO 64086
Phone (816) 251-5710

2790 Clay Edwards Dr
Ste 650
North Kansas City, MO 64116
Phone (816) 459-7500

Practitioners & affiliated clinicians

Practitioners 18

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.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729641600000",
    "number": "1225051618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 CONCORD TER",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333232843",
            "telephone_number": "800-243-3839",
            "fax_number": "844-686-2961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4722 N 24TH ST STE 150",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850164860",
            "telephone_number": "877-885-0588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OBSTETRICS AND PEDIATRICS SUBSPECIALTY GROUP OF KANSAS AND MISSOURI PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-26",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A",
        "authorized_official_last_name": "DWYER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY",
        "authorized_official_telephone_number": "954-384-0175",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0208X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Infectious Diseases",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XP3100X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Pediatric Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100309390A",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100309390B",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "162830002",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.