Active NPI
Evernorth Care Providers - Kansas PA
- General Practice Physician
- Overland Park, KS
National Provider Identifier
1386041234
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- Legal business name
- EVERNORTH CARE PROVIDERS - KANSAS PA
- Practice address
- 9393 W 110TH St Ste 500
Overland Park, KS 66210-1464 - Phone
- (773) 292-4800
- Fax
- (312) 564-4059
- NPI assigned
- Nov 20, 2014
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jacqueline D Lakes
- Title
- Senior Paralegal
- Phone
- (954) 446-0640
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | Primary | ||
| Podiatrist | 213E00000X | |||
| Adult Health Nurse Practitioner | 363LA2200X |
Addresses
Primary practice location
9393 W 110TH St Ste 500
Overland Park, KS 66210-1464
Mailing address
730 Cool Springs Blvd Ste 500
Franklin, TN 37067-7331
Phone (773) 292-4800
National Provider Directory
National Provider DirectoryLocations
7400 W 110th St
Ste 400
Overland Park, KS 66210
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1416441600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1752451200000",
"number": "1386041234",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "730 COOL SPRINGS BLVD STE 500",
"city": "FRANKLIN",
"state": "TN",
"postal_code": "370677331",
"telephone_number": "773-292-4800",
"fax_number": "312-564-4059"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9393 W 110TH ST STE 500",
"city": "OVERLAND PARK",
"state": "KS",
"postal_code": "662101464",
"telephone_number": "773-292-4800",
"fax_number": "312-564-4059"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EVERNORTH CARE PROVIDERS - KANSAS PA",
"organizational_subpart": "NO",
"enumeration_date": "2014-11-20",
"last_updated": "2025-07-14",
"certification_date": "2025-07-14",
"status": "A",
"authorized_official_last_name": "LAKES",
"authorized_official_first_name": "JACQUELINE",
"authorized_official_middle_name": "D",
"authorized_official_title_or_position": "SENIOR PARALEGAL",
"authorized_official_telephone_number": "954-446-0640"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "General Practice",
"state": null,
"license": null,
"primary": true
},
{
"code": "213E00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Podiatrist",
"state": null,
"license": null,
"primary": false
},
{
"code": "363LA2200X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Adult Health",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Overland Park, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.