Jayhawk Primary Care Inc
Organization Active NPI Family Medicine Physician · Independence, MO
NPI 1790742765 · NPPES record last updated Apr 20, 2008
Key facts
- NPI
- 1790742765
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- JAYHAWK PRIMARY CARE INC
- 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
- Organization subpart
- Yes
- Parent organization (as reported)
- JAYHAWK PRIMARY CARE INC
Authorized official
- Name
- Pamela J. Myrtle
- Title
- HR Director
- Phone
- (913) 588-9808
Other NPIs on the same Medicare enrollment 6
Practitioners 19
-
Robert W. Drogan, DO
-
Timothy C. Frey, DO
-
Harry Lounce, MD
-
Nancy C. Moran, MD
-
Diane C Scheuer, DO
-
Huda H. Alani, MD
-
Rita Boswell, PA
-
Paul J. Brown, MD
-
Anne L. Jones, MD
-
Deborah Lockwood, PA-C
-
Van T. Tran, DO
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 |
National Provider Directory
- Part of
- Jayhawk Primary Care Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
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 identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 21211013 | Other | BCBS GROUP NUMBER |
Other names
- FAMILY CARE OF INDEPENDENCE
Other providers in Independence, MO
- Janet E Morgan, MD, PC
- Christopher D Janish
- Tamara Dawn Janssen
- Jason T Vollmecke DC LLC
- Jay Robinson MD PC
- Caitlyn Rose Jayne
- April Jefferson
- Brooke Renee Jehle
- Samantha Renee Jenkins
- Jennifer Lee Jenks
All providers in Independence, MO · Family Medicine Physician in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 20, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.