Midwest Division - Mci, LLC

Primary specialty

General Acute Care HospitalTaxonomy code 282N00000X

Legal business name

MIDWEST DIVISION - MCI, LLC

Doing business as

Medical Center of Independence

Practice address

17203 E 23Rd St S
Independence, MO 64057-1859

Phone

(816) 478-5000

Fax

(816) 836-6603

NPI assigned

May 28, 2006

Organization subpart

No

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

Authorized official

Name

Bryce Dehaven

Title

Cfo

Phone

(816) 836-6602

Specialties & licenses 1

Addresses

Other identifiers 5

Other names 1

• MEDICAL CENTER OF INDEPENDENCE Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Hospital certification: CCN 260166

Legal name

MEDICAL CENTER OF INDEPENDENCE

Certification status

Terminated Voluntary: merger or closure, May 6, 2007

Provider type (POS)

Hospital – Short-term

Participating since

Jan 13, 1970

Last certification

Feb 25, 2000

Beds

205

Ownership / control type

Private (not for profit)

Most recent change of ownership

Apr 1, 2003 (1 total)

Facility address

17203 E 23Rd St
Independence, MO 64057

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

{
    "created_epoch": "1148774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1336196971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17203 E 23RD ST S",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640571859",
            "telephone_number": "816-478-5000",
            "fax_number": "816-836-6603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17203 E 23RD ST S",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640571859",
            "telephone_number": "816-478-5000",
            "fax_number": "816-836-6603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST DIVISION - MCI, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DEHAVEN",
        "authorized_official_first_name": "BRYCE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "816-836-6602"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FAMILY HEALTH PARTNERS",
            "identifier": "756700",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHCARE USA",
            "identifier": "40917",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "90039027",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1707066",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST GUARD",
            "identifier": "515790",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MEDICAL CENTER OF INDEPENDENCE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Acute Care Hospital in Independence, MO
• Providers in Independence, MO by specialty
• General Acute Care Hospital in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.