James Theodore Birch Jr., MD, MSPH
Individual provider Active NPI Family Medicine Physician · Kansas City, KS
NPI 1225080682 · NPPES record last updated Jul 16, 2014
Key facts
- NPI
- 1225080682
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 2003026494 (MO)
- Practice address
- 3901 Rainbow Blvd
Ms 4017
Kansas City, KS 66160-8500 - Phone
- (913) 588-1944
- Fax
- (193) 588-2496
- NPI assigned
- May 16, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050915000822 | MO | Practitioner - Family Practice |
6507895471 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 04032538 | KS | MD | Geriatric Medicine (Family Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Complexcare Medical Group Midwest M PLLC | Current |
Accepting new patients | |
| Theoria Medical | Current |
Accepting new patients | |
| Tiffany Springs Rehabilitation & Health Care Center LLC | Past | Accepting new patients | |
| Theoria Medical | Family Medicine | Past | Accepting new patients |
Locations
41800 W 11 Mile Rd
Ste 109
Novi, MI 48375
Phone (833) 578-2763
3002 John Duffy Dr
Joplin, MO 64804
Phone (417) 553-9767
9191 N Ambassador Dr
Kansas City, MO 64154
Phone (816) 491-6190
4301 NE Parvin Rd
North Kansas City, MO 64117
Phone (816) 444-0900
2150 W Randolph St
Saint Charles, MO 63301
Phone (636) 946-4966
505 W Evergreen St
Strafford, MO 65757
Phone (417) 736-9332
809 W Benton St
Windsor, MO 65360
Phone (660) 467-3102
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 2003026494 | MO | Yes |
| Geriatric Medicine (Family Medicine) Physician | 207QG0300X | 04032538 | KS |
Addresses
Primary practice location
3901 Rainbow Blvd
Ms 4017
Kansas City, KS 66160-8500
Mailing address
PO Box 411851
Kansas City, MO 64141-1851
Phone (913) 588-1944
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 201906013 | Medicaid | MO | |
| 010196264 | Medicaid | VA | |
| P00284544 | Other | MO | RR MEDICARE |
Other providers in Kansas City, KS
- Connie L Bilyeu
- Brianna Rachelle Bingham
- Morgan Taylor Bingham
- Griffin Bins
- Christina M Biondo
- Nicole June Bird
- Cory Daniel Birkestrand
- Mitchell Christian Birt
- Kelly Bisel
- David Bishop
All providers in Kansas City, KS · Family Medicine Physician in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 16, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.