Adult and Pediatric Dermatology
Organization Active NPI Dermatology Physician · Overland Park, KS
NPI 1609966753 · NPPES record last updated Jul 13, 2022
Key facts
- NPI
- 1609966753
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Dermatology Physician 207N00000X
- License
- 0422209 (KS)
- Legal business name
- ADULT AND PEDIATRIC DERMATOLOGY
- Practice address
- 4601 W 109TH St Ste 116
Overland Park, KS 66211-1313 - Phone
- (913) 469-1115
- Fax
- (913) 469-9192
- NPI assigned
- Oct 12, 2006
- Organization subpart
- No
Authorized official
- Name
- Jenean C Kemp
- Title
- Administrator
- Phone
- (913) 948-9184
Practitioners 4
-
Megan E Cummings, PA-C
-
Katherine Rose Duke, APRN
-
David L Kaplan, M.D.
-
John F Rupp, M.D.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 17D0687168 | Adult and Pediatric Dermatology | Provider-performed microscopy | Aug 31, 2027 |
National Provider Directory
Locations
4601 W 109th St
Ste 116
Overland Park, KS 66211
Phone (913) 469-1115
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician |
207N00000X | 0422209 | KS | Yes |
Addresses
Primary practice location
4601 W 109TH St Ste 116
Overland Park, KS 66211-1313
Mailing address
4601 W. 109TH Street
Suite 116
Overland Park, KS 66211-1313
Phone (913) 469-1115
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CI3423 | Other | KS | MEDICARE RAILROAD |
Other providers in Overland Park, KS
- Barbara W Adkins
- Kim R Adkins
- Vishal K Adma
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- Ads Healthcare LLC
- Advanced Arm Dynamics of Kansas City LLC
- Advanced Chiropractic Techniques, PA
- Advanced Dermatologic Surgery, P.a.
- Advanced Healing Group Inc
- Advanced Neurobehavioral Services LLC.
All providers in Overland Park, KS · Dermatology 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 Jul 13, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- 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.