Kansas City Sports Medicine Inc
Organization Active NPI Orthopaedic Surgery Physician · Lansing, KS
NPI 1306133566 · NPPES record last updated Feb 29, 2012
Key facts
- NPI
- 1306133566
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Orthopaedic Surgery Physician 207X00000X
- License
- 04-28802 (KS)
- Legal business name
- KANSAS CITY SPORTS MEDICINE INC
- Practice address
- 712 1St Ter
Lansing, KS 66043-1735 - Phone
- (913) 351-3005
- Fax
- (913) 351-3009
- NPI assigned
- Jul 7, 2011
- Organization subpart
- No
Authorized official
- Name
- Dr. Prem Parmar, M.D.
- Title
- Owner
- Phone
- (913) 351-3005
Practitioners 3
-
Prem Parmar, MD
-
Blake H Donaldson, D.O.
-
Steven Michael Cicero, D.O.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in KS, MO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120319000137 | KS | Part B Supplier - Clinic/Group Practice | 3274792841 |
Receives reassigned benefits from 1 practitioner Practice locations: Shawnee Mission, KS; Overland Park, KS; Olathe, KS; Lenexa, KS; Leavenworth, KS; Lansing, KS; Kansas City, KS; Fort Leavenworth, KS |
| O20130216000022 | MO | Part B Supplier - Clinic/Group Practice | 3274792841 |
Receives reassigned benefits from 1 practitioner Practice locations: Kansas City, MO; Maryville, MO |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician |
207X00000X | 04-28802 | KS | Yes |
Addresses
Primary practice location
712 1St Ter
Lansing, KS 66043-1735
Mailing address
712 1St Ter
Lansing, KS 66043-1735
Phone (913) 351-3005
Other providers in Lansing, KS
- Linda Kay Jensen
- Joel D Foster DPM PC
- John Knox Village
- Jaquan Johnson
- Garret Logan Kahle
- Stephanie Lynn Karleskint
- Jacquelyn S Kemmerer
- De'Anna Maxine Kerr
- Mira Kim
- Brian W Klamm
All providers in Lansing, KS · Orthopaedic Surgery Physician in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 29, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.