Organization Active NPI

Forest Park Neurology, LLC.

  • Specialist
  • Independence, MO
National Provider Identifier
1376804898
Registry record updated May 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
2008002407 Issued in MO
Legal business name
FOREST PARK NEUROLOGY, LLC.
Practice address
3431 S State Route 291
Independence, MO 64057-2341
Phone
(816) 600-1816
Fax
(816) 795-6966
NPI assigned
May 31, 2012
Last updated
May 31, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 31, 2012

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

Authorized official

Name
Dr. Maria Lourdes Donato, M.D.
Title
Office Manager
Phone
(816) 600-1816

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 2008002407 MO Primary

Addresses

Primary practice location

3431 S State Route 291
Independence, MO 64057-2341

Mailing address

3431 S State Route 291
Independence, MO 64057-2341
Phone (816) 600-1816

Other identifiers 1

IdentifierTypeStateIssuer
00002924638 07OtherMOUNITED HEALTHCARE PROVIDER

National Provider Directory

National Provider Directory

Locations

3431 S State Route 291
Independence, MO 64057
Phone (816) 600-1816

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1338422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1338422400000",
    "number": "1376804898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3431 S STATE ROUTE 291",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640572341",
            "telephone_number": "816-600-1816",
            "fax_number": "816-795-6966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3431 S STATE ROUTE 291",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640572341",
            "telephone_number": "816-600-1816",
            "fax_number": "816-795-6966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOREST PARK NEUROLOGY, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-31",
        "last_updated": "2012-05-31",
        "status": "A",
        "authorized_official_last_name": "DONATO",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "LOURDES",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "816-600-1816",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MO",
            "license": "2008002407",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE PROVIDER",
            "identifier": "00002924638 07",
            "state": "MO"
        }
    ],
    "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 May 31, 2012; 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.