1336181718 NPI number — DR. AMY W GEMPERLI M.D.

Table of content: DR. AMY W GEMPERLI M.D. (NPI 1336181718)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336181718 NPI number — DR. AMY W GEMPERLI M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GEMPERLI
Provider First Name:
AMY
Provider Middle Name:
W
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
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:
1336181718
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/11/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8800 W 75TH ST STE 140
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SHAWNEE MISSION
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
66204-4001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
913-362-3210
Provider Business Mailing Address Fax Number:
133-620-4079

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1147 E NORTH AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BELTON
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64012-5105
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-322-6100
Provider Business Practice Location Address Fax Number:
913-362-0407
Provider Enumeration Date:
06/12/2006

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: 207W00000X , with the licence number:  MO-109288 , 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: 24145018 . This is a "BCBS- SL LOCATION" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 24145028 . This is a "BCBS- CC LOCATION" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".




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