1952831422 NPI number — CARELON MEDICAL PARTNERS OF KANSAS, PA

Table of content: (NPI 1952831422)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952831422 NPI number — CARELON MEDICAL PARTNERS OF KANSAS, PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CARELON MEDICAL PARTNERS OF KANSAS, PA
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:
ASPIRE HEALTH MEDICAL PARTNERS OF KANSAS, PA
Provider Other Organization Name Type Code:
4
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:
1952831422
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/23/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
12900 PARK PLAZA DR STE 150
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CERRITOS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90703-9329
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
657-309-1619
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5251 W 116TH PL STE 200
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEAWOOD
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66211-2011
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
844-337-3627
Provider Business Practice Location Address Fax Number:
855-611-1917
Provider Enumeration Date:
06/15/2017

Additional Information

Authorized Official

Authorized Official Last Name:
ALBION
Authorized Official First Name:
TIMOTHY
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
657-309-1619

Provider Taxonomy Codes

  • Taxonomy code: 207RH0002X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2024 www.npivalidator.com