Organization Active NPI

Kansas City Vascular & General Surgery Group LLC

  • Vascular Surgery Physician
  • Overland Park, KS
National Provider Identifier
1295968865
Registry record updated Nov 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
KANSAS CITY VASCULAR & GENERAL SURGERY GROUP LLC
Practice address
10730 Nall Ave
Suite 101
Overland Park, KS 66211-1366
Phone
(913) 754-2800
Fax
(913) 754-2899
NPI assigned
Aug 31, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2025

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

Authorized official

Name
Benjamin Calkins
Title
Group Vice President
Phone
(615) 372-6536

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2086S0129X Primary

Addresses

Primary practice location

10730 Nall Ave
Suite 101
Overland Park, KS 66211-1366

Mailing address

2000 Health Park Dr
Brentwood, TN 37027-4692
Phone (615) 373-7406

Other identifiers 2

IdentifierTypeStateIssuer
200689610AMedicaidKS
1295968865MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, KS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100607000377 MO Part B Supplier - Clinic/Group Practice 8224168927 Receives reassigned benefits from 22 practitioners
Practice locations: Warrensburg, MO; North Kansas City, MO; Liberty, MO; Independence, MO; Lees Summit, MO; Lee'S Summit, MO; Kansas City, MO; Belton, MO…
O20100607000801 KS Part B Supplier - Clinic/Group Practice 8224168927 Receives reassigned benefits from 23 practitioners
Practice locations: Iola, KS; Overland Park, KS

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

2330 E Meyer Blvd
Ste 207
Kansas City, MO 64132

2330 E Meyer Blvd
Ste 115
Kansas City, MO 64132
Phone (816) 607-2940

2000 SE Blue Pkwy
Ste 210
Lees Summit, MO 64063
Phone (816) 607-2950

2000 SE Blue Pkwy
Ste 260
Lees Summit, MO 64063

600 NW Murray Rd
Ste 108
Lees Summit, MO 64081
Phone (816) 282-5985

1980 SE Blue Pkwy
Ste 2120
Lees Summit, MO 64063
Phone (913) 469-6447

2750 Clay Edwards Dr
Ste 320
North Kansas City, MO 64116
Phone (816) 421-0188

Practitioners & affiliated clinicians

Practitioners 46

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

View all 46

NPI Registry JSON

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

{
    "created_epoch": "1251676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763683200000",
    "number": "1295968865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 HEALTH PARK DR",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370274692",
            "telephone_number": "615-373-7406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10730 NALL AVE",
            "address_2": "SUITE 101",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662111366",
            "telephone_number": "913-754-2800",
            "fax_number": "913-754-2899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KANSAS CITY VASCULAR & GENERAL SURGERY GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-31",
        "last_updated": "2025-11-21",
        "certification_date": "2025-11-21",
        "status": "A",
        "authorized_official_last_name": "CALKINS",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_title_or_position": "GROUP VICE PRESIDENT",
        "authorized_official_telephone_number": "615-372-6536"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200689610A",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1295968865",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2025; 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.