Organization Active NPI

Physical Medicine and Rehabilitation Services, Inc.

  • Physical Medicine & Rehabilitation Physician
  • Independence, MO
National Provider Identifier
1336306448
Registry record updated Oct 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
102396 Issued in MO
Legal business name
PHYSICAL MEDICINE AND REHABILITATION SERVICES, INC.
Practice address
3445 S 291 Hwy
Suite 303
Independence, MO 64057-2663
Phone
(816) 373-8715
Fax
(816) 795-9388
NPI assigned
May 18, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2010

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

Authorized official

Name
Ms. Carol Lee Baskin
Title
Practice Manager
Phone
(816) 373-8715

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X 102396 MO Primary
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X 05-27198 KS
Neurology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0400X 2008002407 MO

Addresses

Primary practice location

3445 S 291 Hwy
Suite 303
Independence, MO 64057-2663

Mailing address

3445 S 291 Hwy
Suite 303
Independence, MO 64057-2663
Phone (816) 373-8715

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS, MO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080703000230 KS Part B Supplier - Clinic/Group Practice 1456423656 Receives reassigned benefits from 1 practitioner
Practice locations: Leawood, KS; Overland Park, KS
O20080826000327 MO Part B Supplier - Clinic/Group Practice 1456423656 Receives reassigned benefits from 1 practitioner
Practice locations: Independence, MO

National Provider Directory

National Provider Directory

Locations

5701 W 110th St
Ste 110
Leawood, KS 66211

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1211068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287446400000",
    "number": "1336306448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3445 S 291 HWY",
            "address_2": "SUITE 303",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640572663",
            "telephone_number": "816-373-8715",
            "fax_number": "816-795-9388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3445 S 291 HWY",
            "address_2": "SUITE 303",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640572663",
            "telephone_number": "816-373-8715",
            "fax_number": "816-795-9388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICAL MEDICINE AND REHABILITATION SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-18",
        "last_updated": "2010-10-19",
        "status": "A",
        "authorized_official_last_name": "BASKIN",
        "authorized_official_first_name": "CAROL",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "816-373-8715",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MO",
            "license": "102396",
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "KS",
            "license": "05-27198",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MO",
            "license": "2008002407",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Independence, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2010; 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.