NPIMap

Organization Active NPI

Samuel U. Rodgers Health Center

  • Clinic Pharmacy
  • Kansas City, MO
National Provider Identifier
1265649388
Registry record updated Jun 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic PharmacyTaxonomy code 3336C0002X
License
28254 Issued in MO
Legal business name
SAMUEL U. RODGERS HEALTH CENTER
Practice address
825 Euclid Ave
Kansas City, MO 64124
Phone
(816) 889-4652
Fax
(816) 842-6227
NPI assigned
May 17, 2007
Organization subpart
No

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
Mr. Maybelle M Bowens, BS
Title
Pharmacy Director
Phone
(816) 889-4652

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic Pharmacy 3336C0002X 28254 MO Primary

Addresses

Primary practice location

825 Euclid Ave
Kansas City, MO 64124

Mailing address

825 Euclid Ave
Kansas City, MO 64124-2323
Phone (816) 889-4652

Other identifiers 2

IdentifierTypeStateIssuer
2608086OtherNCPDP
600588412MedicaidMO

National Provider Directory

National Provider Directory
Tax ID family
Samuel Rodgers Comm Ctr11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14088/brand/1/csg/1/fhir/r4

NPI Registry JSON

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528329600000",
    "number": "1265649388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 EUCLID AVE",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641242323",
            "telephone_number": "816-889-4652",
            "fax_number": "816-842-6227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 EUCLID AVE",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "64124",
            "telephone_number": "816-889-4652",
            "fax_number": "816-842-6227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMUEL U. RODGERS HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-17",
        "last_updated": "2018-06-07",
        "status": "A",
        "authorized_official_last_name": "BOWENS",
        "authorized_official_first_name": "MAYBELLE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PHARMACY DIRECTOR",
        "authorized_official_telephone_number": "816-889-4652",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "BS"
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "MO",
            "license": "28254",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "2608086",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "600588412",
            "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.