Shawnee Mission Medical Center Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

SHAWNEE MISSION MEDICAL CENTER INC

Practice address

10824 Shawnee Mission Pkwy
Shawnee, KS 66203-3512

Phone

(913) 297-7472

NPI assigned

Nov 15, 2017

Last updated

Nov 15, 2017By the provider in NPPES

Organization subpart

Yes

Parent organization

SHAWNEE MISSION MEDICAL CENTER INCAs reported in NPPES

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

Authorized official

Name

Karsten Randolph

Title

Evp & Cfo

Phone

(913) 676-2152

Specialties & licenses 1

Addresses

Other names 1

• SPIRA CARE Other name

Medicare fee-for-service enrollment

Enrolled in KS

Enrollment records 1

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Shawnee Mission Medical Center Inc

  • Family Medicine Physician
  • Olathe, KS
  • NPI 1326551144

  O20050701000310

  Same enrollment
• Shawnee Mission Medical Center Inc

  dba AdventHealth Medical Group

  • Family Medicine Physician
  • Merriam, KS
  • NPI 1992735690

  O20050701000310

  Same enrollment

Part of

SMMC

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

{
    "created_epoch": "1510704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1510704000000",
    "number": "1316450133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7315 E FRONTAGE RD STE 101",
            "city": "MERRIAM",
            "state": "KS",
            "postal_code": "662041658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10824 SHAWNEE MISSION PKWY",
            "city": "SHAWNEE",
            "state": "KS",
            "postal_code": "662033512",
            "telephone_number": "913-297-7472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAWNEE MISSION MEDICAL CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SHAWNEE MISSION MEDICAL CENTER INC",
        "enumeration_date": "2017-11-15",
        "last_updated": "2017-11-15",
        "status": "A",
        "authorized_official_last_name": "RANDOLPH",
        "authorized_official_first_name": "KARSTEN",
        "authorized_official_title_or_position": "EVP & CFO",
        "authorized_official_telephone_number": "913-676-2152"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SPIRA CARE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Shawnee Dental Group, PA (Shawnee Modern Dentistry)
• Shawnee Family Care PA
• Shawnee Family Care, PA
• Shawnee Gardens Healthcare and Rehabilitation Center, LLC (Shawnee Gardens Healthcare and Rehabilitation Center)
• Shawnee Health & Rehab LLC (The Cottages at Shawnee)
• Shawnee Mission Medical Center, Inc. (SM Urgent Care)
• Shawnee Mission Medical Center, Inc. (AdventHealth Centra Care)
• Shawnee Oral Surgery, LC
• Theo Sheridan, DC
• Billie Short, PT

• Family Medicine Physician in Shawnee, KS
• Providers in Shawnee, KS by specialty
• Family Medicine Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2017; 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.