Prime Healthcare Kansas City - Physician Services LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

PRIME HEALTHCARE KANSAS CITY - PHYSICIAN SERVICES LLC

Practice address

930 Carondelet Dr Ste 201
Kansas City, MO 64114-4698

Phone

(816) 389-6100

NPI assigned

Feb 12, 2015

Organization subpart

No

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

Authorized official

Name

Christopher Doan

Title

Managing Associate General Counsel

Phone

(310) 259-4706

Specialties & licenses 15

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO, KS2 enrollments

Enrollment records 2

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Prime Healthcare Services - Kansas City, LLC

  • General Acute Care Hospital
  • Kansas City, MO
  • NPI 1528463080

  Member Of

  NPD member

Locations

Practitioners 187

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Hameed Ahmad, M.D.

  • Hospitalist Physician
  • Kansas City, MO
  • NPI 1144437310

  Internal Medicine, MO

  Medicare reassignment Care Compare group NPD
• Muhammed K Banday, MD

  • Internal Medicine Physician
  • Belton, MO
  • NPI 1790071074

  Internal Medicine, MO

  Medicare reassignment Care Compare group NPD
• David J Burkart, MD

  • Vascular & Interventional Radiology Physician
  • Kansas City, MO
  • NPI 1225078488

  KS, MO

  Medicare reassignment Care Compare group NPD
• Luis F. Couchonnal, M.D.

  • Clinical Cardiac Electrophysiology Physician
  • Kansas City, MO
  • NPI 1629287602

  Internal Medicine, KS, MO

  Medicare reassignment Care Compare group NPD
• Justin Crane

  • Physical Medicine & Rehabilitation Physician
  • Kansas City, MO
  • NPI 1851928089

  MO

  Medicare reassignment Care Compare group NPD
• Reda M Daher, D.O.

  • Internal Medicine Physician
  • Kansas City, MO
  • NPI 1972820090

  Internal Medicine, MO

  Medicare reassignment Care Compare group NPD
• Matthew Decker, MD

  • Family Medicine Physician
  • Kansas City, MO
  • NPI 1194385286

  Family Medicine, MO

  Medicare reassignment Care Compare group NPD
• Melissa Ann Dusenberry, APRN

  • Gerontology Nurse Practitioner
  • Kansas City, MO
  • NPI 1174160485

  MO

  Medicare reassignment Care Compare group NPD
• Rebecca L Edwards, MD

  • Hospitalist Physician
  • North Kansas City, MO
  • NPI 1992760292

  Internal Medicine, MO

  Medicare reassignment Care Compare group NPD
• John M Forman, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Kansas City, MO
  • NPI 1992871123

  KS, MO, Thoracic Surgery (Cardiothoracic Vascular Surgery)

  Medicare reassignment Care Compare group NPD
• Nora P Gomez, M.D,

  • Family Medicine Physician
  • Kansas City, MO
  • NPI 1558687582

  Family Medicine, MO

  Medicare reassignment Care Compare group NPD
• Brian Moore Haas, D.O

  • Internal Medicine Physician
  • Kansas City, MO
  • NPI 1033352463

  Internal Medicine, MO

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1423699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630627200000",
    "number": "1427449487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 CARONDELET DR",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641144673",
            "telephone_number": "816-943-2583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 CARONDELET DR STE 201",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641144698",
            "telephone_number": "816-389-6100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Carondelet Dr Ste 201B",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "MO",
            "postal_code": "641144673",
            "country_code": "US",
            "telephone_number": "913-956-2250",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 NW Mock Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Blue Springs",
            "state": "MO",
            "postal_code": "640142500",
            "country_code": "US",
            "telephone_number": "816-228-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "205 NW RD Mize Rd Ste 400",
            "address_purpose": "LOCATION",
            "city": "Blue Springs",
            "state": "MO",
            "postal_code": "64014",
            "country_code": "US",
            "telephone_number": "816-228-9841",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "203 NW RD Mize Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Blue Springs",
            "state": "MO",
            "postal_code": "64014",
            "country_code": "US",
            "telephone_number": "816-220-1117",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3200 NE Ralph Powell Rd",
            "address_purpose": "LOCATION",
            "city": "Lees Summit",
            "state": "MO",
            "postal_code": "640642301",
            "country_code": "US",
            "telephone_number": "816-525-1600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7201 E 147th St Ste 120",
            "address_purpose": "LOCATION",
            "city": "Grandview",
            "state": "MO",
            "postal_code": "640304204",
            "country_code": "US",
            "telephone_number": "913-956-2250",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 Carondelet Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "MO",
            "postal_code": "641144673",
            "country_code": "US",
            "telephone_number": "816-941-9030",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "302 SE Salem St",
            "address_purpose": "LOCATION",
            "city": "Oak Grove",
            "state": "MO",
            "postal_code": "640759299",
            "country_code": "US",
            "telephone_number": "816-690-6566",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1004 Carondelet Dr Ste 440",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "MO",
            "postal_code": "641144845",
            "country_code": "US",
            "telephone_number": "816-943-7777",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 Carondelet Dr",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "MO",
            "postal_code": "641144673",
            "country_code": "US",
            "telephone_number": "816-943-4758",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 Carondelet Dr Ste 200",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "MO",
            "postal_code": "641144673",
            "country_code": "US",
            "telephone_number": "816-942-4500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "930 Carondelet Dr Ste 200",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "MO",
            "postal_code": "641144698",
            "country_code": "US",
            "telephone_number": "816-943-5690",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "206 NW Mock Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Blue Springs",
            "state": "MO",
            "postal_code": "640142530",
            "country_code": "US",
            "telephone_number": "816-416-8633",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PRIME HEALTHCARE KANSAS CITY - PHYSICIAN SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-12",
        "last_updated": "2021-09-03",
        "certification_date": "2021-09-03",
        "status": "A",
        "authorized_official_last_name": "DOAN",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "MANAGING ASSOCIATE GENERAL COUNSEL",
        "authorized_official_telephone_number": "310-259-4706"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2083P0011X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Preventive Medicine, Undersea and Hyperbaric Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500022593",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah Prichard, PMHNP
• Anne-Marie Priebe, DO
• Primary Care North Kansas City LLC
• Prime Health Group Agency LLC
• Prime Health Group LLC
• Prime Healthcare Services - Kansas City LLC
• Prime Healthcare Services - Kansas City LLC
• Prime Healthcare Services - Kansas City, LLC
• Prime Healthcare Services - Kansas City, LLC
• Prime Healthcare Services Kansas City, LLC

• All providers in Kansas City, MO
• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.