Individual provider Active NPI

Molly Kurtz, PA-C

  • Medical Physician Assistant
  • Kansas City, MO
National Provider Identifier
1912328691
Registry record updated Mar 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
2013044925 Issued in MO
Practice address
4240 Blue Ridge Blvd
Suite #611
Kansas City, MO 64133-1713
Phone
(816) 356-2020
Fax
(816) 356-2022
NPI assigned
Dec 23, 2013
Last updated
Mar 16, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 15-01686 KS
Medical Physician Assistant 363AM0700X 2013044925 MO Primary

Addresses

Primary practice location

4240 Blue Ridge Blvd
Suite #611
Kansas City, MO 64133-1713

Mailing address

4240 Blue Ridge Blvd
Suite #611
Kansas City, MO 64133-1713
Phone (816) 356-2020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140508000098 KS Practitioner - Physician Assistant 7315177821 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
15-01686KSMDPhysician Assistant
2013044925MOMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Manning Family Care, LLC Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1387756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394928000000",
    "number": "1912328691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4240 BLUE RIDGE BLVD",
            "address_2": "SUITE #611",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641331713",
            "telephone_number": "816-356-2020",
            "fax_number": "816-356-2022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4240 BLUE RIDGE BLVD",
            "address_2": "SUITE #611",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641331713",
            "telephone_number": "816-356-2020",
            "fax_number": "816-356-2022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KURTZ",
        "first_name": "MOLLY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-23",
        "last_updated": "2014-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KS",
            "license": "15-01686",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MO",
            "license": "2013044925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.