Shawnee Mission Medical Center Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

SHAWNEE MISSION MEDICAL CENTER INC

Practice address

9100 W 74TH St
Merriam, KS 66204-4004

Phone

(913) 676-2000

NPI assigned

Apr 17, 2019

Last updated

Jan 25, 2024By 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

Mairilise Pothin Owen

Title

Cfo

Phone

(913) 676-2153

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in KS

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1235792003. Details of each certification follow.

• CCN 170104 Hospital · Active · Details

Hospital certification: CCN 170104

Legal name

SHAWNEE MISSION MEDICAL CENTER INC

Doing business as

ADVENTHEALTH SHAWNEE MISSION

Certification status

Active

Provider type (POS)

Hospital – Short-term

Participating since

Jun 6, 1988

Last certification

Mar 5, 2024

Beds

504

Ownership / control type

Private (not for profit)

Organization structure

CorporationNon-profit

Enrollment address

9100 W 74TH St
Shawnee Mission, KS 66204-4004
Main/Primary Hospital Location

Hospital subgroups

General, Psychiatric unit

Related certifications (CCN) 1

Facilities connected through Provider of Services related, parent or unit certification numbers.

• Shawnee Mission Medical Center Inc

  • Psychiatric Hospital Unit
  • Merriam, KS
  • NPI 1720142565
  Provider of Services

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Shawnee Mission Medical Center Inc

  dba AdventHealth Shawnee Mission

  • General Acute Care Hospital
  • Merriam, KS
  • NPI 1023171634

  O20030923000057

  Same enrollment

Listed as

Adventhealth Shawnee MissionCCN 170104 · All quality measures

Overall star rating

3 of 5

Type

Acute Care Hospitals

Ownership

Voluntary non-profit - Private

Medicare certification status

ActiveFrom the Provider of Services file

Emergency services

Yes

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

All disclosed owners & managing parties 29

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Samuel K. Caughron, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Lenexa, KS
  • NPI 1538216353

  Corporate Director

  CMS ownership
• Abigail Rose Proffer, M.D.

  • Obstetrics & Gynecology Physician
  • Merriam, KS
  • NPI 1477711356

  Corporate Director

  CMS ownership
• Reagan M Wittek, M.D.

  • Obstetrics & Gynecology Physician
  • Shawnee Mission, KS
  • NPI 1295817492

  Corporate Director

  CMS ownership

Affiliated clinicians 927

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Amel Tareq Abbas, PA

  • Physician Assistant
  • Kansas City, KS
  • NPI 1689142580

  Hospital

  Care Compare affiliation
• Lindsey Bagby Abraham, CRNA

  • Certified Registered Nurse Anesthetist
  • Shawnee Mission, KS
  • NPI 1174159362

  Hospital

  Care Compare affiliation
• Scott Marvin Abraham, MD

  • Orthopaedic Surgery Physician
  • Overland Park, KS
  • NPI 1265659296

  Hospital

  Care Compare affiliation
• Shelly L Acord, CRNA

  • Certified Registered Nurse Anesthetist
  • Shawnee Mission, KS
  • NPI 1295791101

  Hospital

  Care Compare affiliation
• Kristin M Adams, MD

  • Family Medicine Physician
  • Shawnee Mission, KS
  • NPI 1023646346

  Hospital

  Care Compare affiliation
• Emily Katherine Adelman

  • Certified Registered Nurse Anesthetist
  • Kansas City, KS
  • NPI 1962146837

  Hospital

  Care Compare affiliation
• Robb A. Aerni, CRNA

  • Certified Registered Nurse Anesthetist
  • Shawnee Mission, KS
  • NPI 1013984913

  Hospital

  Care Compare affiliation
• Wilberforce Afuya

  • Family Nurse Practitioner
  • Merriam, KS
  • NPI 1518673367

  Hospital

  Care Compare affiliation
• Haseeb Abdul Ahmed, DO

  • Internal Medicine Physician
  • Overland Park, KS
  • NPI 1972701571

  Hospital

  Care Compare affiliation
• M Obadah Al Chekakie, MD

  • Clinical Cardiac Electrophysiology Physician
  • Shawnee Mission, KS
  • NPI 1982853610

  Hospital

  Care Compare affiliation
• Anthony A Albracht, M.D.

  • Interventional Cardiology Physician
  • Merriam, KS
  • NPI 1841299112

  Hospital

  Care Compare affiliation
• Masarah Alfraih, CRNA

  • Certified Registered Nurse Anesthetist
  • Shawnee Mission, KS
  • NPI 1902696248

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1555459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706140800000",
    "number": "1235792003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7315 E FRONTAGE RD STE 202",
            "city": "MERRIAM",
            "state": "KS",
            "postal_code": "662041658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9100 W 74TH ST",
            "city": "MERRIAM",
            "state": "KS",
            "postal_code": "662044004",
            "telephone_number": "913-676-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAWNEE MISSION MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-17",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A",
        "authorized_official_last_name": "POTHIN OWEN",
        "authorized_official_first_name": "MAIRILISE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "913-676-2153"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.13.34.110.1.998.01",
            "affiliationName": "SHAWNEE MISSION MEDICAL CENTER INC",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "7500 Security Boulevard",
            "city": "Baltimore",
            "state": "MD",
            "country_code": "US",
            "postal_code": "21244",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Umang Harshadkumar Shah, M.D., M.P.H.
• Kimberly Kay Shara, DR OF CHIROPRACTIC
• Michael J Shara, D.C.
• Shawnee Mission Health Care, Inc (Trinity Nursing and Rehab Center)
• Shawnee Mission Medical Center Inc (AdventHealth Shawnee Mission)
• Shawnee Mission Medical Center Inc
• Shawnee Mission Medical Center Inc (AdventHealth Medical Group)
• Shawnee Mission Surgery Center LLC (AdventHealth Surgery Center Shawnee Mission)
• Kara Shelman, LCSW
• Randy M Sheridan, M.D.

• Clinical Medical Laboratory in Merriam, KS
• Providers in Merriam, KS by specialty
• Clinical Medical Laboratory in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.