Organization Active NPI

At Provider Group of Kansas PA

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Overland Park, KS
National Provider Identifier
1912777046
Registry record updated Jan 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
AT PROVIDER GROUP OF KANSAS PA
Practice address
9393 W 110TH St Ste 500
Overland Park, KS 66210-1464
Phone
(845) 769-8758
NPI assigned
Jan 9, 2024
Last updated
Jan 9, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2024

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

Authorized official

Name
Karla Renee MullingsNPI 1639415938
Title
Director of Compliance
Phone
(834) 769-8758

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary

Addresses

Primary practice location

9393 W 110TH St Ste 500
Overland Park, KS 66210-1464

Mailing address

1640 Boro PL FL 4
MC Lean, VA 22102-3627
Phone (845) 769-8758

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1704758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704758400000",
    "number": "1912777046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1640 BORO PL FL 4",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221023627",
            "telephone_number": "845-769-8758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9393 W 110TH ST STE 500",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662101464",
            "telephone_number": "845-769-8758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AT PROVIDER GROUP OF KANSAS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-09",
        "last_updated": "2024-01-09",
        "certification_date": "2024-01-09",
        "status": "A",
        "authorized_official_last_name": "MULLINGS",
        "authorized_official_first_name": "KARLA",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "DIRECTOR OF COMPLIANCE",
        "authorized_official_telephone_number": "834-769-8758"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "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 Jan 9, 2024; 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.