Minuteclinic Diagnostic of Kansas PA

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

MINUTECLINIC DIAGNOSTIC OF KANSAS PA

Practice address

3825 S Noland Rd
Independence, MO 64055-3344

Phone

(855) 417-2486

NPI assigned

Jun 8, 2023

Organization subpart

No

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

Authorized official

Name

Deborah Jean Pincince

Title

Administrator

Phone

(401) 770-3813

Specialties & licenses 3

Addresses

Tax ID family

Minuteclinic Diagnostic of Kansas PA3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Minuteclinic Diagnostic of Kansas PA

  • Clinical Social Worker
  • Leawood, KS
  • NPI 1295410066
  NPD tax ID
• Minuteclinic Diagnostic of Kansas PA

  • Family Nurse Practitioner
  • Leawood, KS
  • NPI 1497494181
  NPD tax ID

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

{
    "created_epoch": "1686182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686182400000",
    "number": "1780378984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 772",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028950784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3825 S NOLAND RD",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640553344",
            "telephone_number": "855-417-2486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINUTECLINIC DIAGNOSTIC OF KANSAS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-08",
        "last_updated": "2023-06-08",
        "certification_date": "2023-06-08",
        "status": "A",
        "authorized_official_last_name": "PINCINCE",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "401-770-3813"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mint Dental Independence, LLC.
• Minuteclinic Primary Care Missouri LLC
• Jillian Rose Miranda, RD, LD
• Missouri Caris Healthcare LLC
• Missouri CVS Pharmacy LLC
• Missouri CVS Pharmacy LLC

• All providers in Independence, MO
• Clinical Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2023; 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.