Active NPI
Colleen Renee Cernich, PHYSICIAN ASSISTANT
- Physician Assistant
- Kansas City, MO
National Provider Identifier
1740373935
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 1500668
- Practice address
- 4801 E Linwood Blvd
.
Kansas City, MO 64128-2226 - Phone
- (816) 861-4700
- NPI assigned
- Oct 2, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 1500668 | KS | Primary |
Addresses
Primary practice location
4801 E Linwood Blvd
.
Kansas City, MO 64128-2226
Mailing address
7905 Quail RDG
Parkville, MO 64152-4388
Phone (816) 505-0024
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1500668 | KS | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1740373935",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7905 QUAIL RDG",
"city": "PARKVILLE",
"state": "MO",
"postal_code": "641524388",
"telephone_number": "816-505-0024"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4801 E LINWOOD BLVD",
"address_2": ".",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "641282226",
"telephone_number": "816-861-4700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CERNICH",
"first_name": "COLLEEN",
"middle_name": "RENEE",
"name_prefix": "Mrs.",
"credential": "PHYSICIAN ASSISTANT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "KS",
"license": "1500668",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kansas City, MO
- Centerwell Senior Primary Care Mo PC (CenterWell Senior Primary Care-Bannister Rd)
- Central Care, PA (Central Care Cancer Center)
- Central Division Chiropractic, LLC
- Central States Medical Distributors LLC
- Cep America, LLC (Vituity)
- Joseph Theodore Cernich, M.D.
- Meghan Cernich
- Certified Audiology Distribution, LLC (Pristine Hearing Aid Solutions)
- Jolene M Cerveny, RD
- Samantha Cervetti, LMSW
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.