1922101708 NPI number — DISABILITY MANAGEMENT ASSOC., P.A.

Table of content: (NPI 1922101708)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922101708 NPI number — DISABILITY MANAGEMENT ASSOC., P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DISABILITY MANAGEMENT ASSOC., P.A.
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:
1922101708
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/07/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6400 PROSPECT
Provider Second Line Business Mailing Address:
SUITE 346
Provider Business Mailing Address City Name:
KANSAS CITY
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
64132
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
816-444-1777
Provider Business Mailing Address Fax Number:
816-333-3277

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6400 PROSPECT AVE
Provider Second Line Business Practice Location Address:
SUITE 346
Provider Business Practice Location Address City Name:
KANSAS CITY
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64132
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-444-1777
Provider Business Practice Location Address Fax Number:
816-333-3277
Provider Enumeration Date:
09/06/2006

Additional Information

Authorized Official

Authorized Official Last Name:
HENDLER
Authorized Official First Name:
STEVEN
Authorized Official Middle Name:
L
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
816-444-1777

Provider Taxonomy Codes

  • Taxonomy code: 208100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 26126022 . This is a "BC/BS OF KC" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 103786 . This is a "COVENTRY" identifier . This identifiers is of the category "OTHER".
  • Identifier: CJ8464 . This is a "RAILROAD RETIREMENT" identifier . This identifiers is of the category "OTHER".
  • Identifier: 110742 . This is a "BC/BS OF KANSAS" identifier . This identifiers is of the category "OTHER".
  • Identifier: L750000A . This is a "MEDICARE" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 110742 . This is a "GROUP" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: DD6235 . This is a "RAILROAD RETIREMENT" identifier . This identifiers is of the category "OTHER".
  • Identifier: L750000 . This is a "MEDICARE" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".




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