NPIMap

Organization Active NPI

Shawnee Mission Pediatrics, P.a.

  • Pediatrics Physician
  • Overland Park, KS
National Provider Identifier
1801988688
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
SHAWNEE MISSION PEDIATRICS, P.A.
Practice address
8901 W 74TH St
Suite 10
Overland Park, KS 66204-2204
Phone
(913) 362-1660
Fax
(913) 362-5916
NPI assigned
Sep 29, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Robert Vincent Jackson, M.D.NPI 1033201983
Title
President
Phone
(913) 362-1660

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

8901 W 74TH St
Suite 10
Overland Park, KS 66204-2204

Mailing address

8901 W 74TH St
Suite 10
Overland Park, KS 66204-2204
Phone (913) 362-1660

National Provider Directory

National Provider Directory

Locations

7450 Kessler St
Ste 105
Shawnee Mission, KS 66204
Phone (913) 362-1660

Practitioners & affiliated clinicians

Practitioners 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1801988688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8901 W 74TH ST",
            "address_2": "SUITE 10",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662042204",
            "telephone_number": "913-362-1660",
            "fax_number": "913-362-5916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8901 W 74TH ST",
            "address_2": "SUITE 10",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662042204",
            "telephone_number": "913-362-1660",
            "fax_number": "913-362-5916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAWNEE MISSION PEDIATRICS, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "VINCENT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "913-362-1660",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.