1710949573 NPI number — OPEN MRI OF KANSAS CITY, LLC

Table of content: (NPI 1710949573)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710949573 NPI number — OPEN MRI OF KANSAS CITY, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
OPEN MRI OF KANSAS CITY, LLC
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:
1710949573
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
100 PARAGON DR
Provider Second Line Business Mailing Address:
SUITE 200
Provider Business Mailing Address City Name:
MONTVALE
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07645-1718
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
201-573-8080
Provider Business Mailing Address Fax Number:
201-775-4306

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4907 TOWN CENTER DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEAWOOD
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66211-2057
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
913-491-8500
Provider Business Practice Location Address Fax Number:
913-491-8510
Provider Enumeration Date:
04/05/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BUCHWALTER
Authorized Official First Name:
LAWRENCE
Authorized Official Middle Name:
M.
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
201-573-8080

Provider Taxonomy Codes

  • Taxonomy code: 261QM1200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 261QR0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

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

  • Identifier: 741085 . This is a "COVENTRY HC OF KS" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 1062017 . This is a "FIRST HEALTH NETWORK" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 773231 . This is a "BCBS OF KANSAS" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 5753489 . This is a "AETNA USHC PPO POS" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 16836 . This is a "MEDFOCUS" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 24283017 . This is a "BCBS KANSAS CITY" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: A-70851 . This is a "MULTIPLAN" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 16-00437 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 5034 . This is a "FIRSTGUARD HEALTH PLAN" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 988763 . This is a "AETNA USHC HMO SR" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".




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