1063494177 NPI number — ST LUKES HOSPITAL OF KANSAS CITY

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063494177 NPI number — ST LUKES HOSPITAL OF KANSAS CITY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ST LUKES HOSPITAL OF KANSAS CITY
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
SAINT LUKE'S HOSPITAL OF KANSAS CITY
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1063494177
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/09/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
901 E 104TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KANSAS CITY
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
64131-4517
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
816-932-2000
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4401 WORNALL RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KANSAS CITY
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64111-3220
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-932-2000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/15/2005

Additional Information

Authorized Official

Authorized Official Last Name:
JOHNSON
Authorized Official First Name:
JANI
Authorized Official Middle Name:
L
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
816-932-2000

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X , with the licence number:  87-48 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 291U00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 010326106 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 800057 . This is a "BLUE CROSS" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 90001010 . This is a "BLUE CROSS" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 516640 . This is a "FIRST GUARD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 100099590A , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8840 . This is a "HEALTHCARE USA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 700600 . This is a "FAMILY HEALTH PARTNERS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 65687 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".




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