1972551406 NPI number — DR. JOHN A REANEY MD

Table of content: DR. JOHN A REANEY MD (NPI 1972551406)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972551406 NPI number — DR. JOHN A REANEY MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
REANEY
Provider First Name:
JOHN
Provider Middle Name:
A
Provider Name Prefix Text:
DR.
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:
1972551406
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/09/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9233 WARD PKWY
Provider Second Line Business Mailing Address:
SUITE 230
Provider Business Mailing Address City Name:
KANSAS CITY
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
64114-3366
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
816-389-6030
Provider Business Mailing Address Fax Number:
816-389-6034

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12300 METCALF AVE
Provider Second Line Business Practice Location Address:
ANESTHESIA DEPT
Provider Business Practice Location Address City Name:
OVERLAND PARK
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66213-1324
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-389-6030
Provider Business Practice Location Address Fax Number:
816-389-6034
Provider Enumeration Date:
05/05/2006

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:  106533 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207L00000X , with the licence number: 0427748 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 207641010 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 20990132 . This is a "BCBS NUMBER" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 101160440D , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 207641044 , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 050063983 . This is a "MO RR MEDICARE NUMBER" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 20990022 . This is a "BCBS NUMBER" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 100160440B , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: P00018703 . This is a "KS RR MEDICARE NUMBER" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".




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