Organization Active NPI

Northland Surgical Associates, P.C.

  • Surgery Physician
  • North Kansas City, MO
National Provider Identifier
1558459149
Registry record updated Jun 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
NORTHLAND SURGICAL ASSOCIATES, P.C.
Practice address
2750 Clay Edwards Dr
Suite 404
North Kansas City, MO 64116-3258
Phone
(816) 472-9595
Fax
(816) 472-0038
NPI assigned
Oct 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2010

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

Authorized official

Name
Mark Epstein, M.D.
Title
President
Phone
(816) 472-9595

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

2750 Clay Edwards Dr
Suite 404
North Kansas City, MO 64116-3258

Mailing address

2750 Clay Edwards Dr
Suite 404
North Kansas City, MO 64116-3258
Phone (816) 472-9595

Other identifiers 1

IdentifierTypeStateIssuer
507464402MedicaidMO

National Provider Directory

National Provider Directory

Locations

2750 Clay Edwards Dr
Ste 404
North Kansas City, MO 64116
Phone (816) 472-9595

Practitioners & affiliated clinicians

Practitioners 3

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": "1160438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1275609600000",
    "number": "1558459149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2750 CLAY EDWARDS DR",
            "address_2": "SUITE 404",
            "city": "NORTH KANSAS CITY",
            "state": "MO",
            "postal_code": "641163258",
            "telephone_number": "816-472-9595",
            "fax_number": "816-472-0038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2750 CLAY EDWARDS DR",
            "address_2": "SUITE 404",
            "city": "NORTH KANSAS CITY",
            "state": "MO",
            "postal_code": "641163258",
            "telephone_number": "816-472-9595",
            "fax_number": "816-472-0038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHLAND SURGICAL ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-10",
        "last_updated": "2010-06-04",
        "status": "A",
        "authorized_official_last_name": "EPSTEIN",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "816-472-9595",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "507464402",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Kansas City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2010; 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.