Organization Active NPI

Select Healthcare PA

  • Internal Medicine Physician
  • Overland Park, KS
National Provider Identifier
1689772949
Registry record updated Jun 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
SELECT HEALTHCARE PA
Practice address
12140 Nall Ave Ste 305
Overland Park, KS 66209-2501
Phone
(913) 948-6400
NPI assigned
Sep 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2021

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

Authorized official

Name
Peggy G Davis
Title
Office Administrator
Phone
(913) 948-6400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

12140 Nall Ave Ste 305
Overland Park, KS 66209-2501

Mailing address

12140 Nall Ave Ste 305
Overland Park, KS 66209-2501
Phone (913) 948-6400

Other practice location 1

5701 W 119th St
Ste 345
Overland Park, KS 66209
Phone (913) 888-5577

Other identifiers 9

IdentifierTypeStateIssuer
1679536940OtherDR DAVIS NPI
1740226810OtherROBYN DURST NPI
09414045OtherMODR. DAVIS BLUE CROSS
16807096OtherMODR MONACO BLUE CROSS
09414045OtherID
34603019OtherROBYN DURST BLUE CROSS
1942263215OtherDR MONACO NPI
110141836OtherDR DAVIS RAILROAD MEDICAR
1003852187OtherKIMBERLY NAGEL NPI

National Provider Directory

National Provider Directory

Locations

6700 W 121st St
Ste 200
Overland Park, KS 66209
Phone (913) 491-1500

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": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623196800000",
    "number": "1689772949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12140 NALL AVE STE 305",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662092501",
            "telephone_number": "913-948-6400",
            "fax_number": "913-438-2128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12140 NALL AVE STE 305",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662092501",
            "telephone_number": "913-948-6400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5701 W 119th St",
            "address_2": "Ste 345",
            "address_purpose": "LOCATION",
            "city": "Overland Park",
            "state": "KS",
            "postal_code": "66209",
            "country_code": "US",
            "telephone_number": "913-888-5577",
            "fax_number": "913-438-2128",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SELECT HEALTHCARE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2021-06-09",
        "certification_date": "2021-06-09",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "PEGGY",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OFFICE ADMINISTRATOR",
        "authorized_official_telephone_number": "913-948-6400"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR DAVIS NPI",
            "identifier": "1679536940",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ROBYN DURST NPI",
            "identifier": "1740226810",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR. DAVIS BLUE CROSS",
            "identifier": "09414045",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR MONACO BLUE CROSS",
            "identifier": "16807096",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ID",
            "identifier": "09414045",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ROBYN DURST BLUE CROSS",
            "identifier": "34603019",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR MONACO NPI",
            "identifier": "1942263215",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR DAVIS RAILROAD MEDICAR",
            "identifier": "110141836",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KIMBERLY NAGEL NPI",
            "identifier": "1003852187",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Jun 9, 2021; 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.