1750368023 NPI number — ANTHONY J HAPGOOD MD

Table of content: ANTHONY J HAPGOOD MD (NPI 1750368023)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750368023 NPI number — ANTHONY J HAPGOOD MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HAPGOOD
Provider First Name:
ANTHONY
Provider Middle Name:
J
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
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:
1750368023
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/07/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1028 ROMANY RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KANSAS CITY
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
64113-2015
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
913-782-2292
Provider Business Mailing Address Fax Number:
913-782-2381

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
20375 W 151ST ST
Provider Second Line Business Practice Location Address:
SUITE 306
Provider Business Practice Location Address City Name:
OLATHE
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66061-5306
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
913-782-2292
Provider Business Practice Location Address Fax Number:
913-782-2381
Provider Enumeration Date:
12/28/2005

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: 207L00000X , with the licence number:  2005029306 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207L00000X , with the licence number: 04-31525 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207L00000X , with the licence number: 211-981 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 200358880A , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".
  • Identifier: P01012588 . This is a "RR MEDICARE" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 200358880D , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 207570607 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 207570615 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".




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