NPIMap

Organization Active NPI

Colorectal Surgery Associates PC

  • Colon & Rectal Surgery Physician
  • Overland Park, KS
National Provider Identifier
1730183120
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
Legal business name
COLORECTAL SURGERY ASSOCIATES PC
Practice address
4370 W 109TH St
Suite 350
Overland Park, KS 66211-1361
Phone
(816) 941-0800
Fax
(816) 941-0080
NPI assigned
Jun 13, 2005
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Keri Polton
Title
Office Manager
Phone
(816) 285-8479

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Colon & Rectal Surgery Physician 208C00000X MO Primary

Addresses

Primary practice location

4370 W 109TH St
Suite 350
Overland Park, KS 66211-1361

Mailing address

6060 N Oak Trfy
Suite 101
Gladstone, MO 64118-5130
Phone (816) 941-0800

Other identifiers 2

IdentifierTypeStateIssuer
200298620AMedicaidKS
502936800MedicaidMO

National Provider Directory

National Provider Directory

Locations

11401 Ash St
Leawood, KS 66211
Phone (913) 962-7408

4370 W 109th St
Ste 350
Overland Park, KS 66211

1010 Carondelet Dr
Ste 325
Kansas City, MO 64114
Phone (816) 943-6162

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1730183120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6060 N OAK TRFY",
            "address_2": "SUITE 101",
            "city": "GLADSTONE",
            "state": "MO",
            "postal_code": "641185130",
            "telephone_number": "816-941-0800",
            "fax_number": "816-941-0080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4370 W 109TH ST",
            "address_2": "SUITE 350",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662111361",
            "telephone_number": "816-941-0800",
            "fax_number": "816-941-0080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLORECTAL SURGERY ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-13",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "POLTON",
        "authorized_official_first_name": "KERI",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "816-285-8479"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "MO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200298620A",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "502936800",
            "state": "MO"
        }
    ],
    "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 Jul 21, 2022; 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.