NPIMap

Organization Active NPI

Independence Womens Clinic PC

  • Obstetrics & Gynecology Physician
  • Independence, MO
National Provider Identifier
1427828102
Registry record updated Jul 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
INDEPENDENCE WOMENS CLINIC PC
Practice address
19550 E 39TH St S Ste 300
Independence, MO 64057-2306
Phone
(816) 478-0220
NPI assigned
Jan 4, 2024
Last updated
Jul 6, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2026

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

Authorized official

Name
Timothy Hall, MDNPI 1114921061
Title
President
Phone
(816) 478-0220

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X NU Primary

Addresses

Primary practice location

19550 E 39TH St S Ste 300
Independence, MO 64057-2306

Mailing address

19550 E 39TH St S Ste 300
Independence, MO 64057-2306
Phone (816) 478-0220

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240724004097 MO Part B Supplier - Clinic/Group Practice 2062958119 Receives reassigned benefits from 8 practitioners
Practice locations: Independence, MO

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
26D0442915Independence Womens Clinic, PC19550 E 39TH St S, Suite 300, Independence, MO 64057Provider-performed microscopyAug 31, 2026

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 10

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": "1704326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783296000000",
    "number": "1427828102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19550 E 39TH ST S STE 300",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640572306",
            "telephone_number": "816-478-0220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19550 E 39TH ST S STE 300",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640572306",
            "telephone_number": "816-478-0220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPENDENCE WOMENS CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-04",
        "last_updated": "2026-07-06",
        "certification_date": "2026-07-06",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "816-478-0220",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jul 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.