NPIMap

Organization Active NPI

Jayhawk Primary Care Inc

Doing business as Indian Creek Primary Care

  • Family Medicine Physician
  • Overland Park, KS
National Provider Identifier
1932460177
Registry record updated Jun 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
JAYHAWK PRIMARY CARE INC
Doing business as
Indian Creek Primary Care
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
Last updated
Jun 5, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2012

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

Authorized official

Name
Steven Brown
Title
Director of Billing
Phone
(913) 945-5603

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

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 1

  • Indian Creek Primary Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

Other NPIs on the same Medicare enrollment 11

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

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": "1338854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1338854400000",
    "number": "1932460177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2330 SHAWNEE MISSION PKWY",
            "address_2": "SUITE 312",
            "city": "WESTWOOD",
            "state": "KS",
            "postal_code": "662052005",
            "telephone_number": "913-945-5614",
            "fax_number": "913-945-5617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10777 NALL AVE",
            "address_2": "STE 140",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662111362",
            "telephone_number": "913-754-4599",
            "fax_number": "913-754-3996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAYHAWK PRIMARY CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-05",
        "last_updated": "2012-06-05",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "DIRECTOR OF BILLING",
        "authorized_official_telephone_number": "913-945-5603"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Indian Creek Primary Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jun 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.