1497854822 NPI number — MOWERY REHAB CONSULTANTS, PA

Table of content: (NPI 1497854822)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497854822 NPI number — MOWERY REHAB CONSULTANTS, PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MOWERY REHAB CONSULTANTS, 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:
Provider Other Organization Name Type Code:
6
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:
1497854822
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/03/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
17800 W 106TH ST STE A
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OLATHE
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
66061-2882
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
913-306-7156
Provider Business Mailing Address Fax Number:
913-273-8484

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
17800 W 106TH ST STE A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OLATHE
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66061-2882
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
913-225-9340
Provider Business Practice Location Address Fax Number:
913-271-8484
Provider Enumeration Date:
09/22/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MOWERY
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
913-225-9340

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  11-01721 , 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: 014746 . This is a "BCBSKS" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 370818800 . This is a "OWCP" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 1310946 . This is a "UHMIDWEST" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 22141014 . This is a "BCBSKC" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 4625725 . This is a "AETNA PPO" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 22141014 . This is a "PHP" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 0178177 . This is a "DEPARTMENT OF LABOR WASH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2265205 . This is a "AETNA HMO" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 6290661 . This is a "CIGNA PPO" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 370818800 . This is a "OWCOP PROVIDER NUMBER" identifier . This identifiers is of the category "OTHER".




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