Vein Clinic of Greater Kansas City, P.a.

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

Legal business name

VEIN CLINIC OF GREATER KANSAS CITY, P.A.

Practice address

4400 W 109TH St Ste 150
Overland Park, KS 66211-1319

Phone

(913) 541-3377

Fax

(913) 541-8082

NPI assigned

Nov 2, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Daphene R Roorda

Title

Office Mnager

Phone

(913) 541-3377

Specialties & licenses 5

Addresses

Other identifiers 9

Medicare fee-for-service enrollment

Enrolled in KS, MO2 enrollments

Enrollment records 2

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Craig Douglas Barbieri, M.D.

  • Phlebology Physician
  • Overland Park, KS
  • NPI 1043216336

  MO

  Medicare reassignment
• Gary Dean Bernhardt, M.D.

  • Family Medicine Physician
  • Olathe, KS
  • NPI 1194898361
  NPD (past)
• Alice Dale Martin, RDMS, RVT

  • Vascular Sonography Radiologic Technologist
  • Overland Park, KS
  • NPI 1699964247
  NPD (past)
• Alan L Billsby, DO

  • Surgery Physician
  • Sheffield, AL
  • NPI 1871530766
  NPD (past)
• Lisa M Campeau, M.D.

  • Surgery Physician
  • Covington, LA
  • NPI 1629039318
  NPD (past)
• Naveed H Ismail, MD

  • Surgery Physician
  • Greenwood Village, CO
  • NPI 1427166842
  NPD (past)

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607558400000",
    "number": "1275611444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 W 109TH ST STE 150",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662111319",
            "telephone_number": "913-541-3377",
            "fax_number": "913-541-8082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 W 109TH ST STE 150",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662111319",
            "telephone_number": "913-541-3377",
            "fax_number": "913-541-8082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VEIN CLINIC OF GREATER KANSAS CITY, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-02",
        "last_updated": "2020-12-10",
        "certification_date": "2020-12-10",
        "status": "A",
        "authorized_official_last_name": "ROORDA",
        "authorized_official_first_name": "DAPHENE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OFFICE MNAGER",
        "authorized_official_telephone_number": "913-541-3377",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "0418701",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "KS",
            "license": "0418958",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2471S1302X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiologic Technologist, Sonography",
            "state": null,
            "license": "72262",
            "primary": false
        },
        {
            "code": "2471V0105X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiologic Technologist, Vascular Sonography",
            "state": null,
            "license": "72262",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "09280021",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AENTA HMO",
            "identifier": "844398",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "65228",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "KS0418701",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "434308",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "09509075",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE ARNP",
            "identifier": "45750",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "766289",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD GR",
            "identifier": "08561018",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• VCG Kansas, LLC
• VCG Kansas, LLC
• Vcphcs Xiv, LLC
• John Kyle Veazey, DPT
• Nathan C Veenis, DPT
• Kaylee Brooke Velasquez
• Rajesh Vemulapalli, CRNA
• Jennifer L Vennart, OTR/L
• William Curtis Vennart, MD
• Sreekar Raghuram Vennelaganti, MD

• Vascular Surgery Physician in Overland Park, KS
• Providers in Overland Park, KS by specialty
• Vascular Surgery Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.