NPIMap

Organization Active NPI

Clinical Associates PA

  • Specialist
  • Lenexa, KS
National Provider Identifier
1477588085
Registry record updated Mar 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
CLINICAL ASSOCIATES PA
Practice address
8629 Bluejacket St
Ste 100
Lenexa, KS 66214-1604
Phone
(913) 677-3553
Fax
(913) 677-3282
NPI assigned
Jul 11, 2006
Last updated
Mar 17, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2016

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

Authorized official

Name
Bruce Michael Cappo, PH DNPI 1831134238
Title
Owner/Operator
Phone
(913) 677-3553

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
Specialist 174400000X Primary

Addresses

Primary practice location

8629 Bluejacket St
Ste 100
Lenexa, KS 66214-1604

Mailing address

8629 Bluejacket St
Ste 100
Lenexa, KS 66214-1604
Phone (913) 677-3553

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051029000300 KS Part B Supplier - Clinic/Group Practice 9739084112 Receives reassigned benefits from 49 practitioners
Practice locations: Lenexa, KS

National Provider Directory

National Provider Directory

Locations

8629 Bluejacket St
Overland Park, KS 66214
Phone (913) 677-3553

8629 Bluejacket St
Ste 100
Overland Park, KS 66214
Phone (913) 677-3553

Practitioners & affiliated clinicians

Practitioners 123

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.

View all 123

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458172800000",
    "number": "1477588085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8629 BLUEJACKET ST",
            "address_2": "STE 100",
            "city": "LENEXA",
            "state": "KS",
            "postal_code": "662141604",
            "telephone_number": "913-677-3553",
            "fax_number": "913-677-3282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8629 BLUEJACKET ST",
            "address_2": "STE 100",
            "city": "LENEXA",
            "state": "KS",
            "postal_code": "662141604",
            "telephone_number": "913-677-3553",
            "fax_number": "913-677-3282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICAL ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-11",
        "last_updated": "2016-03-17",
        "status": "A",
        "authorized_official_last_name": "CAPPO",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "913-677-3553",
        "authorized_official_credential": "PH D"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lenexa, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2016; 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.