NPIMap

Organization Active NPI

Independence Medical Group PC

  • Specialist
  • Independence, MO
National Provider Identifier
1255545737
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
103646 Issued in MO
Legal business name
INDEPENDENCE MEDICAL GROUP PC
Practice address
17601 E US Highway 40
Suite S
Independence, MO 64055-5434
Phone
(816) 373-0655
Fax
(816) 478-6374
NPI assigned
May 10, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. William V Andrews, M.D.NPI 1598713646
Title
Physician President
Phone
(816) 373-0655

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 103646 MO Primary

Addresses

Primary practice location

17601 E US Highway 40
Suite S
Independence, MO 64055-5434

Mailing address

17601 E US Highway 40
Suite S
Independence, MO 64055-5434
Phone (816) 373-0655

National Provider Directory

National Provider Directory

Locations

17601 E US Highway 40
Ste S
Independence, MO 64055
Phone (816) 373-0655

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1255545737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17601 E US HIGHWAY 40",
            "address_2": "SUITE S",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640555434",
            "telephone_number": "816-373-0655",
            "fax_number": "816-478-6374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17601 E US HIGHWAY 40",
            "address_2": "SUITE S",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640555434",
            "telephone_number": "816-373-0655",
            "fax_number": "816-478-6374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPENDENCE MEDICAL GROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ANDREWS",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "PHYSICIAN PRESIDENT",
        "authorized_official_telephone_number": "816-373-0655",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "MO",
            "license": "103646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Independence, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.