NPIMap

Organization Active NPI

Samuel U. Rodgers Health Center, Inc.

  • Licensed Practical Nurse
  • Kansas City, MO
National Provider Identifier
1225216211
Registry record updated Jun 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
Legal business name
SAMUEL U. RODGERS HEALTH CENTER, INC.
Practice address
2100 E 9TH St
Kansas City, MO 64124
Phone
(816) 474-4920
Fax
(816) 474-4914
NPI assigned
Feb 1, 2008
Last updated
Jun 7, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
SAMUEL U. RODGERS HEALTH CENTER, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 7, 2018

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

Authorized official

Name
Robert Theis
Title
Acting Ceo
Phone
(816) 889-4802

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical NurseGroup: 193200000X MULTI-SPECIALTY GROUP 164W00000X MO Primary

Addresses

Primary practice location

2100 E 9TH St
Kansas City, MO 64124

Mailing address

2100 E 9TH St
Kansas City, MO 64124-2364
Phone (816) 474-4920

Other identifiers 2

IdentifierTypeStateIssuer
26-1832OtherMOMEDICARE A
170859102MedicaidMO

National Provider Directory

National Provider Directory
Tax ID family
Samuel U Rodgers Comm H11 organizations share this tax ID, including this one
Part of
Samuel U Rodgers Comm H

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1201824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528329600000",
    "number": "1225216211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 E 9TH ST",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641242364",
            "telephone_number": "816-474-4920",
            "fax_number": "816-474-4914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 E 9TH ST",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "64124",
            "telephone_number": "816-474-4920",
            "fax_number": "816-474-4914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMUEL U. RODGERS HEALTH CENTER, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SAMUEL U. RODGERS HEALTH CENTER, INC.",
        "enumeration_date": "2008-02-01",
        "last_updated": "2018-06-07",
        "status": "A",
        "authorized_official_last_name": "THEIS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "ACTING CEO",
        "authorized_official_telephone_number": "816-889-4802"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Licensed Practical Nurse",
            "state": "MO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE A",
            "identifier": "26-1832",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "170859102",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2018; 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.