1922038041 NPI number — DR. SHARON SNAVELY MD

Table of content: DR. SHARON SNAVELY MD (NPI 1922038041)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922038041 NPI number — DR. SHARON SNAVELY MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SNAVELY
Provider First Name:
SHARON
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
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:
1922038041
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/17/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5701 WEST 119TH ST
Provider Second Line Business Mailing Address:
SUITE 240
Provider Business Mailing Address City Name:
OVERLAND PARK
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
66209-3749
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
913-345-8500
Provider Business Mailing Address Fax Number:
913-647-3935

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5701 WEST 119TH ST
Provider Second Line Business Practice Location Address:
SUITE 240
Provider Business Practice Location Address City Name:
OVERLAND PARK
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66209-3749
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
913-345-8500
Provider Business Practice Location Address Fax Number:
913-647-3935
Provider Enumeration Date:
07/04/2006

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: 207R00000X , with the licence number:  418255 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207RI0200X , with the licence number: 418255 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 10489042 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 130393 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 100156490B , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 202256608 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 100003159 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 854764 . This is a "AETNA" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".




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