Active NPI
Select Healthcare PA
- Internal Medicine Physician
- Overland Park, KS
National Provider Identifier
1689772949
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679536940 | Other | DR DAVIS NPI | |
| 1740226810 | Other | ROBYN DURST NPI | |
| 09414045 | Other | MO | DR. DAVIS BLUE CROSS |
| 16807096 | Other | MO | DR MONACO BLUE CROSS |
| 09414045 | Other | ID | |
| 34603019 | Other | ROBYN DURST BLUE CROSS | |
| 1942263215 | Other | DR MONACO NPI | |
| 110141836 | Other | DR DAVIS RAILROAD MEDICAR | |
| 1003852187 | Other | KIMBERLY NAGEL NPI |
National Provider Directory
National Provider DirectoryLocations
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.
-
- Chiropractor
- Overland Park, KS
- NPI 1891760732
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.