Novamed Eye Surgery Center (Plaza), LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

79-8 Issued in MO

Legal business name

NOVAMED EYE SURGERY CENTER (PLAZA), LLC

Practice address

4321 Washington St
Ste 6000
Kansas City, MO 64111-5933

Phone

(816) 753-6511

Fax

(816) 227-4099

NPI assigned

Jun 28, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Scott Macomber

Title

Evp of the Manager

Phone

(312) 664-4100

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1119916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1851397434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 E HIGGINS RD",
            "address_2": "STE 240",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600183888",
            "telephone_number": "847-296-5700",
            "fax_number": "847-296-5990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4321 WASHINGTON ST",
            "address_2": "STE 6000",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641115933",
            "telephone_number": "816-753-6511",
            "fax_number": "816-227-4099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVAMED EYE SURGERY CENTER (PLAZA), LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MACOMBER",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "EVP OF THE MANAGER",
        "authorized_official_telephone_number": "312-664-4100",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "MO",
            "license": "79-8",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Casandra Nowak, PT, DPT

• All providers in Kansas City, MO
• Ambulatory Surgical Clinic/Center in Missouri

• 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.