Jayhawk Primary Care Inc
Organization Active NPI Family Medicine Physician · Overland Park, KS
NPI 1932460177 · NPPES record last updated Jun 5, 2012
Key facts
- NPI
- 1932460177
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- JAYHAWK PRIMARY CARE INC
- Practice address
- 10777 Nall Ave
Ste 140
Overland Park, KS 66211-1362 - Phone
- (913) 754-4599
- Fax
- (913) 754-3996
- NPI assigned
- Jun 5, 2012
- Organization subpart
- No
Authorized official
- Name
- Steven Brown
- Title
- Director of Billing
- Phone
- (913) 945-5603
Other NPIs on the same Medicare enrollment 11
Practitioners 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050721001078 | KS | Part B Supplier - Clinic/Group Practice | 8123928900 |
Receives reassigned benefits from 208 practitioners 11 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Overland Park, KS; Westwood, KS; Shawnee, KS; Prairie Village, KS; Olathe, KS; Gardner, KS |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
10777 Nall Ave
Ste 140
Overland Park, KS 66211-1362
Mailing address
2330 Shawnee Mission Pkwy
Suite 312
Westwood, KS 66205-2005
Phone (913) 945-5614
Other names
- Indian Creek Primary Care
Other providers in Overland Park, KS
- Ahmad Javed
- Lama Jawhari
- Jay Enterprise LLC
- Jay L. Richardson MD Chartered
- Jayhawk Primary Care Inc
- Jayhawk Primary Care Inc
- Jared Jaynes
- Drake Jayroe
- Jcofjc LLC
- Elizabeth Jayne Jeffers
All providers in Overland Park, KS · Family Medicine Physician in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 5, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.