Dr. J.a. Direnna Jr, P.C.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

R6C32 Issued in MO

Legal business name

DR. J.A. DIRENNA JR, P.C.

Practice address

1 The Woodlands
Gladstone, MO 64119-1853

Phone

(816) 225-1643

Fax

(913) 248-9383

NPI assigned

Feb 13, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

James A Direnna Jr., DO

Title

Director

Phone

(816) 225-1643

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1336281534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2181",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640550081",
            "telephone_number": "913-248-9693",
            "fax_number": "913-248-9383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 THE WOODLANDS",
            "city": "GLADSTONE",
            "state": "MO",
            "postal_code": "641191853",
            "telephone_number": "816-225-1643",
            "fax_number": "913-248-9383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. J.A. DIRENNA JR, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DIRENNA",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "816-225-1643",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "R6C32",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD KC",
            "identifier": "19739014",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.