Primary Care Center of Kansas City LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

D0101786 Issued in MO

Legal business name

PRIMARY CARE CENTER OF KANSAS CITY LLC

Practice address

4741 S Arrowhead
Suite B
Independence, MO 64055

Phone

(816) 795-6000

Fax

(816) 795-6064

NPI assigned

Oct 4, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Jan Lynn Johnson, DO

Title

Physician Owner

Phone

(816) 795-6000

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Primary Care Center of Kansas City Other name

Locations

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210723200000",
    "number": "1386739035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 480497",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "64148",
            "telephone_number": "816-795-6000",
            "fax_number": "816-795-6064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4741 S ARROWHEAD",
            "address_2": "SUITE B",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "64055",
            "telephone_number": "816-795-6000",
            "fax_number": "816-795-6064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY CARE CENTER OF KANSAS CITY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2008-05-14",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "JAN",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "816-795-6000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "MO",
            "license": "D0101786",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "248700718",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Primary Care Center of Kansas City",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Primary Care Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2008; 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.