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PROVIDENCE MEDICAL GROUP NPI 1952947939


NPI Information

NPI: 1952947939
Provider Name: PROVIDENCE MEDICAL GROUP
Classification: Orthopaedic Surgery - 207XX0005X
Entity Type: Organization

Specialization: Sports Medicine

CLIA Number: 17D0448945

Address:
8919 PARALLEL PKWY STE 555
KANSAS CITY, KS
ZIP 66112
Phone: (913) 596-3930
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PROVIDENCE MEDICAL GROUP is a sports medicine orthopaedic surgery in Kansas City, KS. The provider is an orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries. PROVIDENCE MEDICAL GROUP NPI is 1952947939. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

8919 PARALLEL PKWY STE 555
KANSAS CITY, KS
ZIP 66112-628
Phone: (913) 596-3930

The provider's authorized official is Diedre Mcdaniel .
The authorized official title is Medical Staff Office and has the following contact phone number (913) 596-4000.

The CLIA number assigned to this NPI record is 17D0448945 - hospital with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 11/25/2019 and was last updated on 11/26/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207XX0005XOrthopaedic SurgerySports MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11598741472OTHERKANSASNPI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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