Active NPI
Heartland Physician Services, LLC
- Family Medicine Physician
- Kansas City, MO
National Provider Identifier
1669585766
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 101923
- Legal business name
- HEARTLAND PHYSICIAN SERVICES, LLC
- Doing business as
- Kansas City Family Medical Care
- Practice address
- 1004 Carondelet Dr
Ste 300a
Kansas City, MO 64114-4801 - Phone
- (816) 941-9030
- Fax
- (816) 941-3866
- NPI assigned
- Aug 16, 2006
- Organization subpart
- Yes
- Parent organization
- HEALIENT PHYSICIAN GROUP
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Pam Gavin
- Title
- Practice Manager
- Phone
- (816) 941-9030
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 101923 | MO | Primary |
Addresses
Primary practice location
1004 Carondelet Dr
Ste 300a
Kansas City, MO 64114-4801
Mailing address
1004 Carondelet Dr
Ste 300a
Kansas City, MO 64114-4801
Phone (816) 941-9030
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MA4728 | Other | MO | MEDICARE PTAN |
Other names 1
- Kansas City Family Medical Care
National Provider Directory
National Provider Directory- Part of
- Heartland Physician Services LLC
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155686400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1401926400000",
"number": "1669585766",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1004 CARONDELET DR",
"address_2": "STE 300A",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "641144801",
"telephone_number": "816-941-9030",
"fax_number": "816-941-3866"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1004 CARONDELET DR",
"address_2": "STE 300A",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "641144801",
"telephone_number": "816-941-9030",
"fax_number": "816-941-3866"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HEARTLAND PHYSICIAN SERVICES, LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "HEALIENT PHYSICIAN GROUP",
"enumeration_date": "2006-08-16",
"last_updated": "2014-06-05",
"status": "A",
"authorized_official_last_name": "GAVIN",
"authorized_official_first_name": "PAM",
"authorized_official_title_or_position": "PRACTICE MANAGER",
"authorized_official_telephone_number": "816-941-9030"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": "MO",
"license": "101923",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "MA4728",
"state": "MO"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Kansas City Family Medical Care",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Kansas City, MO
- Heartland Family Chiropractic
- Heartland Family Dentistry Inc
- Heartland Family Dentistry Inc
- Heartland Health Services of Kansas City, Inc.
- Heartland Hematology Oncology Associates Inc
- Heartland Strategic Solutions LLC
- Heartland Surgical Associates
- Heartland Toxicology, LLC
- Heartland Wellness LLC
- Heartland Wellness LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.