NPIMap

Organization Active NPI

Jayhawk Primary Care Inc

  • Physical Therapist
  • Kansas City, KS
National Provider Identifier
1740313634
Registry record updated May 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
JAYHAWK PRIMARY CARE INC
Practice address
4810 State Ave
State Avenue Therapy
Kansas City, KS 66102-1748
Phone
(913) 321-4567
Fax
(913) 321-6789
NPI assigned
Mar 13, 2007
Organization subpart
Yes
Parent organization
JAYHAWK PRIMARY CARE INCAs reported in NPPES

Authorized official

NPPES NPI Registry
Name
Angela Mauch
Title
Director of Physician Revenue
Phone
(913) 588-6711

Other NPIs on the same Medicare enrollment 11

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Practitioners 7

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050721001078 KS Part B Supplier - Clinic/Group Practice 8123928900 Receives reassigned benefits from 208 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Overland Park, KS; Westwood, KS; Shawnee, KS; Prairie Village, KS; Olathe, KS; Gardner, KS

National Provider Directory

National Provider Directory
Part of
Jayhawk Primary Care Inc

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X

Addresses

NPPES NPI Registry

Primary practice location

4810 State Ave
State Avenue Therapy
Kansas City, KS 66102-1748

Mailing address

2330 Shawnee Mission Pkwy
Medical Administrative Services of Ku Med, Ste.312
Westwood, KS 66205-2005
Phone (913) 588-9000

Other names 1

NPPES NPI Registry
  • STATE AVENUE THERAPY Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 14, 2020.

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589414400000",
    "number": "1740313634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2330 SHAWNEE MISSION PKWY",
            "address_2": "MEDICAL ADMINISTRATIVE SERVICES OF KU MED, STE.312",
            "city": "WESTWOOD",
            "state": "KS",
            "postal_code": "662052005",
            "telephone_number": "913-588-9000",
            "fax_number": "913-588-9822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4810 STATE AVE",
            "address_2": "STATE AVENUE THERAPY",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661021748",
            "telephone_number": "913-321-4567",
            "fax_number": "913-321-6789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAYHAWK PRIMARY CARE INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JAYHAWK PRIMARY CARE INC",
        "enumeration_date": "2007-03-13",
        "last_updated": "2020-05-14",
        "certification_date": "2020-05-14",
        "status": "A",
        "authorized_official_last_name": "MAUCH",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "DIRECTOR OF  PHYSICIAN REVENUE",
        "authorized_official_telephone_number": "913-588-6711"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "STATE AVENUE THERAPY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "STATE AVENUE THERAPY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kansas City, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2020; 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.