Excelsior Springs Physician Clinic LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

EXCELSIOR SPRINGS PHYSICIAN CLINIC LLC

Practice address

25610 Park Rd N
Lawson, MO 64062-8938

Phone

(816) 630-6722

NPI assigned

Nov 13, 2018

Last updated

Nov 13, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Cameron Meyer

Title

Cfo

Phone

(816) 629-2763

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1542067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1542067200000",
    "number": "1851860498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 RAINBOW BLVD",
            "city": "EXCELSIOR SPRINGS",
            "state": "MO",
            "postal_code": "640241182",
            "telephone_number": "816-630-6081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25610 PARK RD N",
            "city": "LAWSON",
            "state": "MO",
            "postal_code": "640628938",
            "telephone_number": "816-630-6722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCELSIOR SPRINGS PHYSICIAN CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-13",
        "last_updated": "2018-11-13",
        "status": "A",
        "authorized_official_last_name": "MEYER",
        "authorized_official_first_name": "CAMERON",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "816-629-2763"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QS1000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Student Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cameron Regional Medical Center Inc (Lawson Medical Clinic)
• Laura Carder
• Madison Paige Cenkus, FNP-C
• Alyson Marie Dorrell-Ruhl
• Excelsior Springs City Hospital (Lawson Primary Care)
• Samuel Warren Jameson III, D.C.
• Kanning Dental LLC
• Larry G. Kanning, D.D.S.
• Nelson Carter Kanning, D.D.S.
• Angela Dawn Knaack, RN

• Clinic/Center in Lawson, MO
• Providers in Lawson, MO by specialty
• Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2018; 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.