Organization Active NPI

Mobile Anesthesia Care, LLC

  • Anesthesiology Physician
  • Overland Park, KS
National Provider Identifier
1457778169
Registry record updated Mar 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
MOBILE ANESTHESIA CARE, LLC
Practice address
8717 W 110TH St
Suite 600
Overland Park, KS 66210-2144
Phone
(913) 428-2900
Fax
(913) 428-2951
NPI assigned
Mar 20, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2021

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

Authorized official

Name
Ryan Grindstaff, MD
Title
President
Phone
(913) 428-2900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X Primary

Addresses

Primary practice location

8717 W 110TH St
Suite 600
Overland Park, KS 66210-2144

Mailing address

8717 W 110TH St
Suite 600
Overland Park, KS 66210-2144
Phone (913) 428-2900

Other identifiers 4

IdentifierTypeStateIssuer
100000590BMedicaidKS
00053011OtherMOBLUECROSS/BLUESHIELD
500513601MedicaidMO
100000590AMedicaidKS

Other names 1

  • Mobile Anesthesia Care Former legal business name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1395273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616544000000",
    "number": "1457778169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8717 W 110TH ST",
            "address_2": "SUITE 600",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662102144",
            "telephone_number": "913-428-2900",
            "fax_number": "913-428-2951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8717 W 110TH ST",
            "address_2": "SUITE 600",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662102144",
            "telephone_number": "913-428-2900",
            "fax_number": "913-428-2951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBILE ANESTHESIA CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-20",
        "last_updated": "2021-03-24",
        "certification_date": "2021-03-24",
        "status": "A",
        "authorized_official_last_name": "GRINDSTAFF",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "913-428-2900",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100000590B",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS/BLUESHIELD",
            "identifier": "00053011",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500513601",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100000590A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mobile Anesthesia Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mobile Anesthesia Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mobile Anesthesia Care",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 Mar 24, 2021; 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.