Jayhawk Primary Care Inc
Organization Active NPI Family Medicine Physician · Shawnee, KS
NPI 1528025053 · NPPES record last updated Apr 9, 2012
Key facts
- NPI
- 1528025053
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- JAYHAWK PRIMARY CARE INC
- Practice address
- 7405 Renner Rd
Ku Medwest
Shawnee, KS 66217-9414 - Phone
- (913) 588-8400
- Fax
- (913) 588-8413
- NPI assigned
- Apr 27, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- JAYHAWK PRIMARY CARE INC
Authorized official
- Name
- Steven Brown
- Title
- Billing Director
- Phone
- (913) 945-5603
Other NPIs on the same Medicare enrollment 11
Other NPIs with the same Medicare PAC ID 1
Practitioners 234
-
Amanda Jo Adams, APRN
-
Mistee Michelle Allen, M.D.
-
Gregory Alan Anderson, DNP, FNP-C
-
Kelly Andra, M.D.
-
Mariah J Andrews, MD
-
Robert Andrews, MD
-
Kristine Guzman Arano, M.D.
-
Michael Morgan Bergman, A.R.N.P.
-
Patrick Joseph Boos, APRN
-
Jordan Kristene Brennan, RN, BSN
-
Linda Louise Bunten, FNP
-
Sarah E Butell, PA
-
Alisa B Cahill, MD
-
Cory Tyson Carpenter, D.O.
-
Joshua Chan, DO, MBA
-
Angela K Dailing, FNP
-
Jennifer Rae Dixon, APRN
-
Eric Lee Dyck, MD
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 17D1004841 | Tukhs Ku Medwest - Specialty Clinic | Provider-performed microscopy | Aug 3, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050721001078 | KS | Part B Supplier - Clinic/Group Practice | 8123928900 |
Receives reassigned benefits from 208 practitioners 11 other NPIs on this enrollment Practice locations: Overland Park, KS; Westwood, KS; Shawnee, KS; Prairie Village, KS; Olathe, KS; Gardner, KS |
National Provider Directory
- Part of
- Jayhawk Primary Care Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes | ||
| Internal Medicine Physician |
207R00000X | |||
| Pediatrics Physician |
208000000X | |||
| Physical Therapist |
225100000X | |||
| Occupational Therapist |
225X00000X |
Addresses
Primary practice location
7405 Renner Rd
Ku Medwest
Shawnee, KS 66217-9414
Mailing address
2330 Shawnee Mission Pkwy
Medical Administrative Services of Ku Med. Ste. 312
Westwood, KS 66205-2005
Phone (913) 588-9000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 25562019 | Other | BCBS GROUP NUMBER | |
| 100217070C | Medicaid | KS |
Other names
- KU MEDWEST
Other providers in Shawnee, KS
- Kelly Jarczyk
- Jasbro Health Care Services Inc
- Sarah Jasim
- Zachary Alan Jaskinia
- Jayhawk Primary Care Inc
- Jayhawk Primary Care Inc
- Emily Nicole Jaynes
- Jenian, Inc.
- Jenkins Pediatric Dentistry
- Crystal D. Jenkins
All providers in Shawnee, KS · Family Medicine Physician in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 9, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.