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CENTERWELL SENIOR PRIMARY CARE KS PA NPI 1104347756


NPI Information

NPI: 1104347756
Provider Name: CENTERWELL SENIOR PRIMARY CARE KS PA

Doing Business As: CENTERWELL SENIOR PRIMARY CARE- STATE AVENUE

Classification: Internal Medicine - 207R00000X
Entity Type: Organization

CLIA Number: 17D2136731

Address:
7527 STATE AVE
KANSAS CITY, KS
ZIP 66112
Phone: (913) 335-6986
Get Directions

CENTERWELL SENIOR PRIMARY CARE KS PA is an internal medicine in Kansas City, KS. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. CENTERWELL SENIOR PRIMARY CARE KS PA NPI is 1104347756. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Centerwell Senior Primary Care- State Avenue.

The provider's business location address is:

7527 STATE AVE
KANSAS CITY, KS
ZIP 66112-815
Phone: (913) 335-6986
Fax: (855) 446-7151

The provider's authorized official is Angie Martinez .
The authorized official title is Senior Credentialing Professional and has the following contact phone number (407) 447-7120.

The CLIA number assigned to this NPI record is 17D2136731 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/5/2017 and was last updated on 3/14/2024.


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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineNo
2207R00000XInternal MedicineYes
3208D00000XGeneral PracticeNo

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: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.