College Park Endoscopy Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

COLLEGE PARK ENDOSCOPY CENTER LLC

Doing business as

College Park Surgery Center

Practice address

10787 Nall Ave
Suite 100
Overland Park, KS 66211-1375

Phone

(913) 652-9255

NPI assigned

Nov 11, 2016

Last updated

Oct 8, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

David McKnight

Title

VP/Cfo

Phone

(972) 789-2816

Specialties & licenses 1

Addresses

Other names 1

• College Park Surgery Center Doing business as

Medicare fee-for-service enrollment

Enrolled in KS

Enrollment records 1

Listed as

College Park Endoscopy Center LLCCCN 17C0001092

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1478822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1791417600000",
    "number": "1629510326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10787 NALL AVE STE 100",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662111373",
            "telephone_number": "913-385-4400",
            "fax_number": "913-385-4450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10787 NALL AVE",
            "address_2": "SUITE 100",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662111375",
            "telephone_number": "913-652-9255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLEGE PARK ENDOSCOPY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-11",
        "last_updated": "2026-10-08",
        "certification_date": "2026-10-08",
        "status": "A",
        "authorized_official_last_name": "MCKNIGHT",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "VP/CFO",
        "authorized_official_telephone_number": "972-789-2816"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "College Park Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Whitney T Coleman, O.D.
• Colin N Mackenzie MD LC
• Michael Allan-Joseph Colin, LPC, LMAC, CTP, NCC
• College Park Ancillary, LLC (College Park Physical Therapy)
• College Park Ancillary, LLC
• College Park Family Care Center PA
• College Park Family Care Center, P.a.
• College Park Family Care Center, P.a.
• College Park Family Care Center, P.a.
• College Park Family Care Center, P.a.

• Ambulatory Surgical Clinic/Center in Overland Park, KS
• Providers in Overland Park, KS by specialty
• Ambulatory Surgical Clinic/Center in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.