Organization Active NPI

Stanley Park Family Medicine LLC

  • Primary Care Clinic/Center
  • Overland Park, KS
National Provider Identifier
1740341205
Registry record updated Jun 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
0420781 Issued in KS
Legal business name
STANLEY PARK FAMILY MEDICINE LLC
Practice address
8631 W 150TH St
Suite 101
Overland Park, KS 66223-2294
Phone
(913) 681-3399
Fax
(913) 851-0037
NPI assigned
Dec 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2015

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

Authorized official

Name
Jeanette Ramirez
Title
Office Manager
Phone
(913) 681-3399

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 0420781 KS Primary

Addresses

Primary practice location

8631 W 150TH St
Suite 101
Overland Park, KS 66223-2294

Mailing address

8631 W 150TH St
Suite 101
Overland Park, KS 66223-2294
Phone (913) 681-3399

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050315000282 KS Part B Supplier - Clinic/Group Practice 7517912314 Receives reassigned benefits from 1 practitioner
Practice locations: Overland Park, KS

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
17D1003700Stanley Park Family Medicine8631 W 150TH, Suite 101, Overland Park, KS 66223Certificate of waiverSep 8, 2026

National Provider Directory

National Provider Directory

Locations

8631 W 150th St
Ste 101
Overland Park, KS 66223
Phone (913) 322-6606

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434585600000",
    "number": "1740341205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8631 W 150TH ST",
            "address_2": "SUITE 101",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662232294",
            "telephone_number": "913-681-3399",
            "fax_number": "913-851-0037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8631 W 150TH ST",
            "address_2": "SUITE 101",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662232294",
            "telephone_number": "913-681-3399",
            "fax_number": "913-851-0037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STANLEY PARK FAMILY MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-12",
        "last_updated": "2015-06-18",
        "status": "A",
        "authorized_official_last_name": "RAMIREZ",
        "authorized_official_first_name": "JEANETTE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "913-681-3399"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "KS",
            "license": "0420781",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.