NPIMap

Organization Active NPI

Kansas Medical Center, LLC

Doing business as Andover Cardiology

  • Cardiovascular Disease Physician
  • Andover, KS
National Provider Identifier
1952585341
Registry record updated Aug 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
KANSAS MEDICAL CENTER, LLC
Doing business as
Andover Cardiology
Practice address
1124 W 21St St
Andover, KS 67002-5500
Phone
(316) 300-4000
NPI assigned
Dec 21, 2007
Last updated
Aug 13, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
KANSAS MEDICAL CENTER, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 13, 2024

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

Authorized official

Name
Mr. Steven Hadley
Title
Chief Business Executive
Phone
(316) 300-4021

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X NU Primary

Addresses

Primary practice location

1124 W 21St St
Andover, KS 67002-5500

Mailing address

PO Box 268938
Oklahoma City, OK 73126-8938
Phone (316) 300-4021

Other identifiers 2

IdentifierTypeStateIssuer
111401OtherKSBCBSKS
200408390EMedicaidKS

Other names 1

  • Andover Cardiology Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS, OK2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20061109000659 KS Part B Supplier - Clinic/Group Practice 2668476862 Receives reassigned benefits from 64 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Andover, KS; Wichita, KS; Neodosha, KS; Meade, KS; Liberal, KS; Kingman, KS; Independence, KS; Fredonia, KS…
O20250219000305 OK Part B Supplier - Hospital Department(S) 2668476862 Receives reassigned benefits from 2 practitioners
Practice locations: Ponca City, OK

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 4

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

National Provider Directory

National Provider Directory
Part of
Kansas Medical Center LLC

Locations

1124 W 21st St
#100
Andover, KS 67002
Phone (316) 440-3200

1124 W 21st St
Ste 310
Andover, KS 67002

811 W Laurel St
Independence, KS 67301
Phone (620) 332-2528

2134 N Kansas Ave
Liberal, KS 67901
Phone (620) 624-1500

122 E Grand Ave
Ponca City, OK 74601
Phone (580) 203-8270

Practitioners & affiliated clinicians

Practitioners 58

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.

View all 58

NPI Registry JSON

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

{
    "created_epoch": "1198195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723507200000",
    "number": "1952585341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 268938",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731268938",
            "telephone_number": "316-300-4021",
            "fax_number": "316-300-4040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1124 W 21ST ST",
            "city": "ANDOVER",
            "state": "KS",
            "postal_code": "670025500",
            "telephone_number": "316-300-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KANSAS MEDICAL CENTER, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KANSAS MEDICAL CENTER, LLC",
        "enumeration_date": "2007-12-21",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A",
        "authorized_official_last_name": "HADLEY",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "CHIEF BUSINESS EXECUTIVE",
        "authorized_official_telephone_number": "316-300-4021",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSKS",
            "identifier": "111401",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200408390E",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Andover Cardiology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Andover, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2024; 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.