Organization Active NPI

Matrix Medical Network of Kansas PA

  • Nurse Practitioner
  • Overland Park, KS
National Provider Identifier
1669770095
Registry record updated Dec 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
MATRIX MEDICAL NETWORK OF KANSAS PA
Practice address
9393 W 110TH St Ste 500
Overland Park, KS 66210-1464
Phone
(480) 862-1716
Fax
(480) 718-7643
NPI assigned
Mar 9, 2011
Organization subpart
Yes
Parent organization
COMMUNITY CARE HEALTH NETWORK INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 11, 2019

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

Authorized official

Name
Victoria Alvarez
Title
Director, Credentialing
Phone
(480) 862-1695

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363L00000X Primary

Addresses

Primary practice location

9393 W 110TH St Ste 500
Overland Park, KS 66210-1464

Mailing address

9201 E Mountain View Rd
Suite 220
Scottsdale, AZ 85258-5172
Phone (480) 862-1700

Other names 1

  • Matrix Medical Network Doing business as

National Provider Directory

National Provider Directory
Part of
Community Care Health

Practitioners & affiliated clinicians

Practitioners 1

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": "1299628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576022400000",
    "number": "1669770095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9201 E MOUNTAIN VIEW RD",
            "address_2": "SUITE 220",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852585172",
            "telephone_number": "480-862-1700",
            "fax_number": "480-907-1537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9393 W 110TH ST STE 500",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662101464",
            "telephone_number": "480-862-1716",
            "fax_number": "480-718-7643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATRIX MEDICAL NETWORK OF KANSAS PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMMUNITY CARE HEALTH NETWORK INC",
        "enumeration_date": "2011-03-09",
        "last_updated": "2019-12-11",
        "certification_date": "2019-12-11",
        "status": "A",
        "authorized_official_last_name": "ALVAREZ",
        "authorized_official_first_name": "VICTORIA",
        "authorized_official_title_or_position": "DIRECTOR, CREDENTIALING",
        "authorized_official_telephone_number": "480-862-1695"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Matrix Medical Network",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Matrix Medical Network",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Overland Park, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2019; 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.