1700395878 NPI number — UNIVERSITY OF KANSAS HOSPITAL AUTHORITY

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 1700395878 NPI number — UNIVERSITY OF KANSAS HOSPITAL AUTHORITY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UNIVERSITY OF KANSAS HOSPITAL AUTHORITY
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:
6
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:
1700395878
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/01/2022
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:
MAIL STOP 4040
Provider Business Mailing Address City Name:
KANSAS CITY
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
66160-8500
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
913-588-2361
Provider Business Mailing Address Fax Number:
913-588-2385

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3825 CAMBRIDGE ST
Provider Second Line Business Practice Location Address:
STE 1333
Provider Business Practice Location Address City Name:
KANSAS CITY
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66103-2883
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
913-574-3100
Provider Business Practice Location Address Fax Number:
913-574-3182
Provider Enumeration Date:
09/21/2017

Additional Information

Authorized Official

Authorized Official Last Name:
JOHNSON
Authorized Official First Name:
JAMIE
Authorized Official Middle Name:
Authorized Official Title or Position:
ASSISTANT DIRECTOR
Authorized Official Telephone Number:
785-760-3318

Provider Taxonomy Codes

  • Taxonomy code: 3336C0003X , with the licence number:  2103863 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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