1184041964 NPI number — ADAM ZERR NP

Table of content: ADAM ZERR NP (NPI 1184041964)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184041964 NPI number — ADAM ZERR NP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ZERR
Provider First Name:
ADAM
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
NP
Provider Gender Code:
M

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:
1184041964
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/14/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
810 RAVEN HILL DRIVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ATCHISON
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
66002
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
913-367-7300
Provider Business Mailing Address Fax Number:
970-874-2475

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
444 MINNESOTA AVE
Provider Second Line Business Practice Location Address:
SUITE 126
Provider Business Practice Location Address City Name:
KANSAS CITY
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66101
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
913-342-2552
Provider Business Practice Location Address Fax Number:
970-874-1631
Provider Enumeration Date:
03/18/2014

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: 363LF0000X , with the licence number:  APN.0991114-NP , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LF0000X , with the licence number: 53-78403-032 , 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)

  • Identifier: 04825048 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".




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