1891965984 NPI number — DR. SUSAN M ANSCHUTZ D.C.

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 1891965984 NPI number — DR. SUSAN M ANSCHUTZ D.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ANSCHUTZ
Provider First Name:
SUSAN
Provider Middle Name:
M
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.C.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
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:
1891965984
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/14/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
19501 E US HIGHWAY 40 STE B
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
INDEPENDENCE
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
64055-5475
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
816-795-5000
Provider Business Mailing Address Fax Number:
816-795-5001

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
19501 E US HIGHWAY 40 STE B
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
INDEPENDENCE
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64055-5475
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-795-5000
Provider Business Practice Location Address Fax Number:
816-795-5001
Provider Enumeration Date:
03/05/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  2008002552 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 11950405 . This is a "CAQH" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 1013037597 . This is a "BATEMAN-GATROST, PC GROUP NPI" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".




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