1053457978 NPI number — KANSAS UNIVERSITY PHYSICIANS INC

Table of content: (NPI 1053457978)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1053457978 NPI number — KANSAS UNIVERSITY PHYSICIANS INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KANSAS UNIVERSITY PHYSICIANS INC
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:
KU OBSTETRIC & GYNECOLOGY
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:
1053457978
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/20/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3901 RAINBOW BLVD
Provider Second Line Business Mailing Address:
4070 DELP MAIL STOP 4017
Provider Business Mailing Address City Name:
KANSAS CITY
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
66160
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
913-588-2500
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
G013 WAHL EAST KU MEDICAL CENTER
Provider Second Line Business Practice Location Address:
MAIL STOP 2028 3901 RAINBOW BLVD
Provider Business Practice Location Address City Name:
KANSAS CITY
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66160
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
913-588-2500
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/29/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BRANSON
Authorized Official First Name:
DON
Authorized Official Middle Name:
Authorized Official Title or Position:
DEPARTMENT ADMINISTRATOR
Authorized Official Telephone Number:
913-588-2500

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207VE0102X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207VX0201X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 01812031 . This is a "BCBS KC GRP NUMBER" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 500567805 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 100217430M , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 026152 . This is a "BCBS KS GRP NUMBER" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".