1144417049 NPI number — DAVID G. SMITHSON, MD PC

Table of content: (NPI 1144417049)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144417049 NPI number — DAVID G. SMITHSON, MD PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DAVID G. SMITHSON, MD PC
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:
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:
1144417049
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/16/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1000 CARONDELET DR
Provider Second Line Business Mailing Address:
MAIL STOP #9
Provider Business Mailing Address City Name:
KANSAS CITY
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
64114-4673
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
816-943-4554
Provider Business Mailing Address Fax Number:
816-943-4654

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1010 CARONDELET DR
Provider Second Line Business Practice Location Address:
SUITE 329
Provider Business Practice Location Address City Name:
KANSAS CITY
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64114-4859
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-943-4554
Provider Business Practice Location Address Fax Number:
816-943-4654
Provider Enumeration Date:
09/25/2007

Additional Information

Authorized Official

Authorized Official Last Name:
SMITHSON
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
GERARD
Authorized Official Title or Position:
MEDICAL DIRECTOR INPT. REHAB UNIT
Authorized Official Telephone Number:
816-943-4554

Provider Taxonomy Codes

  • Taxonomy code: 273Y00000X , with the licence number:  R8N64 , 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: 100120320-B , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 16504022 . This is a "BC/BS KANSAS CITY" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 36374011 . This is a "BLUE CROSS BLUE SHIELD KC" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 0000556265 . This is a "BC/BS" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 207674409 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 208100000X . This is a "PROIVIDER TAXONOMIE" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 1417947755 . This is a "PROVIDER NPI" identifier . This identifiers is of the category "OTHER".
  • Identifier: R8N64 . This is a "PHYSICIAN LICENSE" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 04-23432 . This is a "PHYSICIAN LICENSE" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 250002027 . This is a "RR: MEDICARE" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".




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