NPIMap

Organization Active NPI

Brookside Health Services, Inc.

  • Occupational Medicine Physician
  • Kansas City, MO
National Provider Identifier
1801950589
Registry record updated Oct 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Medicine PhysicianTaxonomy code 2083X0100X
License
R5D43 Issued in MO
Legal business name
BROOKSIDE HEALTH SERVICES, INC.
Practice address
7337 Broadway St
Kansas City, MO 64114-1357
Phone
(816) 523-4600
Fax
(816) 523-4724
NPI assigned
Dec 20, 2006
Last updated
Oct 26, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2011

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

Authorized official

Name
Michael Kelly Miller, DCNPI 1093892119
Title
Ceo
Phone
(816) 523-4600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Medicine Physician 2083X0100X R5D43 MO Primary
Physical Therapist 225100000X 2006023685 MO
Rehabilitation Chiropractor 111NR0400X 004675 MO

Addresses

Primary practice location

7337 Broadway St
Kansas City, MO 64114-1357

Mailing address

7337 Broadway St
Kansas City, MO 64114-1357
Phone (816) 523-4600

Other identifiers 7

IdentifierTypeStateIssuer
1093892119OtherM. KELLY MILLER, DC NPI#
12973019OtherMOGROUP BCBS NUMBER
1619088879OtherRAMON NICHOLS, MD NPI#
4598983OtherMOAETNA GROUP NUMBER
09455022OtherMODR MILLER BCBS#
12455029OtherMODR NICHOLS BCBS#
756879607MedicaidMO

National Provider Directory

National Provider Directory

Locations

7337 Broadway
Kansas City, MO 64114
Phone (816) 523-4600

Practitioners & affiliated clinicians

Practitioners 14

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 14

NPI Registry JSON

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319587200000",
    "number": "1801950589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7337 BROADWAY ST",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641141357",
            "telephone_number": "816-523-4600",
            "fax_number": "816-523-4724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7337 BROADWAY ST",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641141357",
            "telephone_number": "816-523-4600",
            "fax_number": "816-523-4724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKSIDE HEALTH SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-20",
        "last_updated": "2011-10-26",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "KELLY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "816-523-4600",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "MO",
            "license": "R5D43",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2006023685",
            "primary": false
        },
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "MO",
            "license": "004675",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "M. KELLY MILLER, DC  NPI#",
            "identifier": "1093892119",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP BCBS NUMBER",
            "identifier": "12973019",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAMON NICHOLS, MD  NPI#",
            "identifier": "1619088879",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA GROUP NUMBER",
            "identifier": "4598983",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR MILLER    BCBS#",
            "identifier": "09455022",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR NICHOLS    BCBS#",
            "identifier": "12455029",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "756879607",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2011; 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.