Individual provider Active NPI

Jane P Brunner, D.O.

  • Family Medicine Physician
  • Overland Park, KS
National Provider Identifier
1417944836
Registry record updated Dec 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0531266 Issued in KS
Practice address
11725 W 112TH St
Overland Park, KS 66210-2761
Phone
(913) 469-5579
Fax
(913) 338-1311
NPI assigned
Sep 30, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0531266 KS Primary

Addresses

Primary practice location

11725 W 112TH St
Overland Park, KS 66210-2761

Mailing address

PO Box 741331
Atlanta, GA 30374-1331
Phone (913) 469-0503

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050602001211 MO Practitioner - Family Practice 6002859857 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Kansas City University of Med & Biosciences, College of Osteo Med, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Health PhysiciansGroup PAC ID 1153235825, 344 clinicians

Practice addresses (Care Compare)

1439 S Minter Way
Grain Valley Family Medical Care
Grain Valley, MO 64029-9648
Phone (816) 404-6785

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0531266KSMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Health Physicians Family Medicine CurrentSince Jul 2, 2024 Accepting new patients
College Park Family Care Center, P.a. Past Accepting new patients
Truman Medical Center, Incorporated Past Accepting new patients

Locations

20333 W 151st St
Olathe, KS 66061
Phone (888) 960-1393

1439 S Minter Way
Grain Valley, MO 64029
Phone (816) 404-6785

4407 E 50th Ter
Kansas City, MO 64130
Phone (816) 924-1201

7900 Lees Summit Rd
Kansas City, MO 64139
Phone (816) 373-4485

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356912000000",
    "number": "1417944836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 741331",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303741331",
            "telephone_number": "913-469-0503",
            "fax_number": "913-469-5267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11725 W 112TH ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662102761",
            "telephone_number": "913-469-5579",
            "fax_number": "913-338-1311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNNER",
        "first_name": "JANE",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-30",
        "last_updated": "2012-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "0531266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

Verify at the official NPI Registry.