NPIMap

Organization Active NPI

Jayhawk Primary Care Inc

Doing business as Family Care of Independence

  • Family Medicine Physician
  • Independence, MO
National Provider Identifier
1790742765
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
JAYHAWK PRIMARY CARE INC
Doing business as
Family Care of Independence
Practice address
4721 S Cliff Ave
Family Care of Independence Suite 200
Independence, MO 64055-7016
Phone
(816) 503-3700
Fax
(816) 503-3704
NPI assigned
Apr 26, 2006
Last updated
Apr 20, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
JAYHAWK PRIMARY CARE INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Authorized official

Name
Pamela J. Myrtle
Title
HR Director
Phone
(913) 588-9808

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

4721 S Cliff Ave
Family Care of Independence Suite 200
Independence, MO 64055-7016

Mailing address

2330 Shawnee Mission Pkwy
Medical Administrative Services of Ku Med. Ste. 312
Westwood, KS 66205-2005
Phone (913) 588-9856

Other names 1

  • FAMILY CARE OF INDEPENDENCE Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040120000219 MO Part B Supplier - Clinic/Group Practice 8123928900 Receives reassigned benefits from 27 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Kansas City, MO; Grandview, MO; Gladstone, MO

Other NPIs on the same Medicare enrollment 6

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

National Provider Directory

National Provider Directory
Part of
Jayhawk Rimary Care

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1790742765",
    "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": "913-588-9856",
            "fax_number": "913-588-9822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4721 S CLIFF AVE",
            "address_2": "FAMILY CARE OF INDEPENDENCE SUITE 200",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640557016",
            "telephone_number": "816-503-3700",
            "fax_number": "816-503-3704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAYHAWK PRIMARY CARE INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JAYHAWK PRIMARY CARE INC",
        "enumeration_date": "2006-04-26",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "MYRTLE",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "HR DIRECTOR",
        "authorized_official_telephone_number": "913-588-9808"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FAMILY CARE OF INDEPENDENCE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Independence, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; 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.