Northland Orthopedics & Sports Medicine, LLC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

Legal business name

NORTHLAND ORTHOPEDICS & SPORTS MEDICINE, LLC

Practice address

2790 Clay Edwards Dr
Ste 1230
North Kansas City, MO 64116-3276

Phone

(816) 214-9300

Fax

(816) 214-9330

NPI assigned

Nov 4, 2016

Organization subpart

No

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

Authorized official

Name

Steven B Smith, M.D.

Title

Owner

Phone

(816) 841-3805

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Locations

Practitioners 6

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

• Jessica Lynn Hall

  • Physician Assistant
  • Lee's Summit, MO
  • NPI 1558837799
  Medicare reassignment NPD
• Lacey Renee Nelson, PA-C

  • Surgical Physician Assistant
  • N Kansas City, MO
  • NPI 1639467806
  Medicare reassignment NPD
• John Swab, D.O.

  • Orthopaedic Surgery Physician
  • Kansas City, MO
  • NPI 1881076198
  Medicare reassignment NPD
• Dustin S Woyski, D.O.

  • Orthopaedic Surgery Physician
  • North Kansas City, MO
  • NPI 1255777660
  Medicare reassignment NPD
• Miranda Maberry

  • Family Nurse Practitioner
  • Overland Park, KS
  • NPI 1295499812

  MO

  Medicare reassignment NPD
• Jeremy Michael Ross, M.D.

  • Family Medicine Physician
  • Muskogee, OK
  • NPI 1063890697
  NPD (past)

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

{
    "created_epoch": "1478217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1730621988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 W 6TH ST",
            "address_2": "STE B #105",
            "city": "LAWRENCE",
            "state": "KS",
            "postal_code": "660493205",
            "telephone_number": "785-403-0405",
            "fax_number": "785-222-4504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2790 CLAY EDWARDS DR",
            "address_2": "STE 1230",
            "city": "NORTH KANSAS CITY",
            "state": "MO",
            "postal_code": "641163276",
            "telephone_number": "816-214-9300",
            "fax_number": "816-214-9330"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5844 NW Barry Rd Ste 320",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "MO",
            "postal_code": "641541421",
            "country_code": "US",
            "telephone_number": "816-841-3805",
            "fax_number": "816-214-9330",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NORTHLAND ORTHOPEDICS & SPORTS MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-04",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "816-841-3805",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "MO",
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MO",
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "MO",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Northland Adult Day Center LLC
• Northland Anesthesiology Inc
• Northland Bone & Joint, Inc
• Northland General Surgery, PC
• Northland Neurological Associates, P.C.
• Northland Surgical Associates, P.C.
• Douglas Nulph, PHARMD
• Molly O'Brien, DO
• Joley Beeler O'Callahan, MD
• Kenna J O'Sullivan, CRNA

• Medical Specialty Clinic/Center in North Kansas City, MO
• Providers in North Kansas City, MO by specialty
• Medical Specialty Clinic/Center in Missouri

• 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.
• 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.