1568992675 NPI number — ROCKHILL ORTHOPAEDIC SPECIALISTS INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568992675 NPI number — ROCKHILL ORTHOPAEDIC SPECIALISTS INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ROCKHILL ORTHOPAEDIC SPECIALISTS INC
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:
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:
1568992675
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/13/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
120 NE SAINT LUKES BLVD STE 200
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LEES SUMMIT
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
64086-6011
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
816-246-4302
Provider Business Mailing Address Fax Number:
816-246-8910

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
600 NE ADAMS DAIRY PKWY STE 160
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BLUE SPRINGS
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64014-5496
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-246-4302
Provider Business Practice Location Address Fax Number:
816-246-9493
Provider Enumeration Date:
06/13/2017

Additional Information

Authorized Official

Authorized Official Last Name:
MARINO
Authorized Official First Name:
MATT
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
816-347-4891

Provider Taxonomy Codes

  • Taxonomy code: 174400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 6684830001 . This is a "MEDICARE NSC" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: MA3922 . This is a "MEDICARE UPIN" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com