Serc Rehabilitation Partners, LLC

Key facts

NPI: 1629403290
Entity type: Organization (NPI type 2)
Primary specialty: Occupational Medicine Clinic/Center 261QX0100X
Legal business name: SERC REHABILITATION PARTNERS, LLC
Practice address: 3355 Main St
Kansas City, MO 64111-1904
Phone: (816) 399-0806
Fax: (816) 399-0801
NPI assigned: Sep 13, 2013
Organization subpart: No

Authorized official

Name: Kiley Russell
Title: Manager
Phone: (423) 238-7217

National Provider Directory

Specialties & licenses

Specialty (taxonomy)	Code	Primary
Multi-Specialty Clinic/Center	261QM1300X
Rehabilitation Clinic/Center	261QR0400X
Occupational Medicine Clinic/Center	261QX0100X	Yes

Addresses

Primary practice location

3355 Main St
Kansas City, MO 64111-1904

Mailing address

17134 Bel Ray PL
Belton, MO 64012-5331
Phone (816) 318-0436

Other names

SERC Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 13, 2013.

{
    "created_epoch": "1379030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379030400000",
    "number": "1629403290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17134 BEL RAY PL",
            "city": "BELTON",
            "state": "MO",
            "postal_code": "640125331",
            "telephone_number": "816-318-0436",
            "fax_number": "816-318-0437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3355 MAIN ST",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641111904",
            "telephone_number": "816-399-0806",
            "fax_number": "816-399-0801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERC REHABILITATION PARTNERS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-13",
        "last_updated": "2013-09-13",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "KILEY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "423-238-7217"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QX0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Occupational Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SERC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kansas City, MO

All providers in Kansas City, MO · Occupational Medicine Clinic/Center in Missouri

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 13, 2013. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.