1740273465 NPI number — KENNETH STEVEN BRATON DO

Table of content: KENNETH STEVEN BRATON DO (NPI 1740273465)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740273465 NPI number — KENNETH STEVEN BRATON DO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BRATON
Provider First Name:
KENNETH
Provider Middle Name:
STEVEN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DO
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:
1740273465
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/08/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2330 SHAWNEE MISSION PKWY
Provider Second Line Business Mailing Address:
MEDICAL ADMINISTRATIVE SERVICES OF KU MED, STE. 312
Provider Business Mailing Address City Name:
WESTWOOD
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
66205-2005
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
913-945-5614
Provider Business Mailing Address Fax Number:
913-945-5617

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1000 E 101ST TER
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:
64131-3366
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
913-945-9660
Provider Business Practice Location Address Fax Number:
913-945-9659
Provider Enumeration Date:
08/28/2005

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: 207Q00000X , with the licence number:  R9426 , 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: 18960020 . This is a "CFU BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: P00324156 . This is a "RR MEDICARE#" identifier . This identifiers is of the category "OTHER".
  • Identifier: 22039026 . This is a "BCBS PHF AFTER HOURS UC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 37157012 . This is a "BCBS HIGHLAND MEDICAL" identifier . This identifiers is of the category "OTHER".
  • Identifier: 4001323 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 481159444 . This is a "JHPC TAX ID" identifier . This identifiers is of the category "OTHER".




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