1417993676 NPI number — DR. ROLAND SABATES MD

Table of content: DR. ROLAND SABATES MD (NPI 1417993676)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417993676 NPI number — DR. ROLAND SABATES MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SABATES
Provider First Name:
ROLAND
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
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:
1417993676
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/18/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
520 E 63RD ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KANSAS CITY
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
64110-3330
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
816-333-8600
Provider Business Mailing Address Fax Number:
816-444-3304

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
520 E 63RD ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KANSAS CITY
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64110-3330
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-333-8600
Provider Business Practice Location Address Fax Number:
816-444-3304
Provider Enumeration Date:
06/22/2006

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-R3C19 , 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: 201750437 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 09720149 . This is a "BCBS-CC LOCATION" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 09720119 . This is a "BCBS" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 09720109 . This is a "BCBS- SL LOCATION" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 100133460A , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com