1972616522 NPI number — REHAB MEDICAL OF KANSAS CITY, LLC

Table of content: (NPI 1972616522)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972616522 NPI number — REHAB MEDICAL OF KANSAS CITY, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
REHAB MEDICAL 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:
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:
1972616522
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/25/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3750 PRIORITY WAY SOUTH DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
INDIANAPOLIS
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
46240-3831
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
317-436-6178
Provider Business Mailing Address Fax Number:
855-671-9194

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9730 PFLUMM RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LENEXA
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66215-1206
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-761-0110
Provider Business Practice Location Address Fax Number:
816-761-0114
Provider Enumeration Date:
08/17/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MCGINLEY
Authorized Official First Name:
PATRICK
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
317-813-0205

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , with the licence number:  12115 , 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)





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