1700678430 NPI number — KU MEDWEST AMBULATORY SURGERY CENTER, L.L.C.

Table of content: PHILIP MATTHEW ACKER DDS (NPI 1326158114)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700678430 NPI number — KU MEDWEST AMBULATORY SURGERY CENTER, L.L.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KU MEDWEST AMBULATORY SURGERY CENTER, L.L.C.
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:
1700678430
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/19/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
12000 W 151ST ST STE 200
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:
66062-7200
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
913-942-5701
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12000 W 151ST ST STE 200
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:
66062-7200
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
913-942-5701
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/19/2025

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
JASNOSKI
Authorized Official First Name:
STEPHANIE
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR OF ASC OPERATIONS
Authorized Official Telephone Number:
913-574-1794

Provider Taxonomy Codes

  • Taxonomy code: 261QA1903X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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