Shawnee Mission Internal Medicine LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

SHAWNEE MISSION INTERNAL MEDICINE LLC

Practice address

11661 College Blvd Ste 100
Overland Park, KS 66210-4104

Phone

(913) 954-8500

NPI assigned

Jul 16, 2024

Organization subpart

No

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

Authorized official

Name

Michelle Benkhadra

Title

Credentialier

Phone

(913) 954-8500

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KS

Enrollment records 1

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ammar Khalifa, MD

  • Internal Medicine Physician
  • Overland Park, KS
  • NPI 1780677948
  Medicare reassignment Care Compare group NPD
• Shannon Ortman, APRN-C

  • Adult Health Nurse Practitioner
  • Overland Park, KS
  • NPI 1710300074
  Medicare reassignment Care Compare group NPD
• April Maiyo, FNP

  • Family Nurse Practitioner
  • Overland Park, KS
  • NPI 1528717659
  Medicare reassignment NPD

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

{
    "created_epoch": "1721088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721088000000",
    "number": "1720826548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11661 COLLEGE BLVD STE 100",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662104104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11661 COLLEGE BLVD STE 100",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662104104",
            "telephone_number": "913-954-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAWNEE MISSION INTERNAL MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-16",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A",
        "authorized_official_last_name": "BENKHADRA",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "CREDENTIALIER",
        "authorized_official_telephone_number": "913-954-8500"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ann Marie Shaughnessy, PTA
• Dawson Scott Shaver, M.D.
• Emily Claire Shaw, RD, LD
• Shawna Shaw, MFT
• Shawnee Mission Health Care, Inc
• Shawnee Mission Medical Center Inc
• Shawnee Mission Medical Center Inc
• Shawnee Mission Medical Center, Inc.
• Shawnee Mission Open MRI, LLC
• Shawnee Mission Pediatrics, P.a.

• Internal Medicine Physician in Overland Park, KS
• Providers in Overland Park, KS by specialty
• Internal Medicine Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.