EXCELSIOR SPRINGS PHYSICIANS CLINIC NPI 1629491105

NPI Information

  • NPI: 1629491105
  • Provider Name: EXCELSIOR SPRINGS PHYSICIANS CLINIC
  • Classification: Family Medicine - 207QA0000X
  • Specialization: Adolescent Medicine
  • Entity Type: Organization
  • Address: 1700 RAINBOW BLVD
    EXCELSIOR SPRINGS, MO
    ZIP 64024
  • Phone: (816) 629-2623

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NPI Details

EXCELSIOR SPRINGS PHYSICIANS CLINIC is an adolescent medicine family medicine in Excelsior Springs, MO. The provider is a family medicine physician with multidisciplinary training in the unique physical, psychological and social characteristics of adolescents and their health care problems and needs. EXCELSIOR SPRINGS PHYSICIANS CLINIC NPI is 1629491105. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1700 RAINBOW BLVD
EXCELSIOR SPRINGS, MO
ZIP 64024-182
Phone: (816) 629-2623
Fax: (816) 629-2722

The provider's authorized official is Jennifer L Boomgarden .
The authorized official title is Physicians Practice Manager and has the following contact phone number (816) 629-2623.

The enumeration date for this NPI number is 2/4/2014 and was last updated on 2/4/2014.

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
1207QA0000XFamily MedicineAdolescent MedicineR6J43MISSOURIYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1MA 4388OTHERMISSOURIMEDICARE ID#

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: 11/21/2025

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