NPIMap

Organization Active NPI

Epc Mo Aco LLC

  • Internal Medicine Physician
  • Lees Summit, MO
National Provider Identifier
1346824570
Registry record updated May 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
EPC MO ACO LLC
Practice address
400 SW Longview Blvd Ste 200
Lees Summit, MO 64081-2116
Phone
(737) 226-6700
NPI assigned
May 12, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2021

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

Authorized official

Name
Antonio Gamboa, MD
Title
Owner
Phone
(737) 226-6700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

400 SW Longview Blvd Ste 200
Lees Summit, MO 64081-2116

Mailing address

3901A Spicewood Springs Rd Ste 201
Austin, TX 78759-8728
Phone (737) 226-6700

National Provider Directory

National Provider Directory

Locations

9100 Park St
Ste 100
Lenexa, KS 66215
Phone (913) 712-9680

Practitioners & affiliated clinicians

Practitioners 3

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": "1620777600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620777600000",
    "number": "1346824570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901A SPICEWOOD SPRINGS RD STE 201",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787598728",
            "telephone_number": "737-226-6700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 SW LONGVIEW BLVD STE 200",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640812116",
            "telephone_number": "737-226-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EPC MO ACO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-12",
        "last_updated": "2021-05-12",
        "certification_date": "2021-05-12",
        "status": "A",
        "authorized_official_last_name": "GAMBOA",
        "authorized_official_first_name": "ANTONIO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "737-226-6700",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lees Summit, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2021; 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.