| Doc Shop, Pa | |
|
5407 Johnson Dr Mission KS 66205-2912 | |
| (913) 362-0220 | |
| (913) 362-0440 |
| Full Name | Doc Shop, Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 5407 Johnson Dr, Mission, Kansas |
| Authorized Official Name and Position | Sharon D. Lee (PRESIDENT) |
| Authorized Official Contact | 9133620220 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Doc Shop, Pa 5407 Johnson Dr Mission KS 66205-2912 Ph: (913) 362-0220 | Doc Shop, Pa 5407 Johnson Dr Mission KS 66205-2912 Ph: (913) 362-0220 |
| NPI Number | 1275139305 |
|---|---|
| Provider Enumeration Date | 12/04/2020 |
| Last Update Date | 11/02/2022 |
| Medicare PECOS PAC ID | 6002229697 |
|---|---|
| Medicare Enrollment ID | O20201228000912 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275139305 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Sharon D Lee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154439081 PECOS PAC ID: 7214004118 Enrollment ID: I20080918000361 |
| Provider Name | Robert E Jevons |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386704732 PECOS PAC ID: 1658402367 Enrollment ID: I20100624000363 |
| Provider Name | Kenyada J Gilbert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386200442 PECOS PAC ID: 4284006099 Enrollment ID: I20230203001469 |
Prime Care Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5417 Johnson Dr, Mission, KS 66205 Phone: 913-261-9479 | |
Kc Wellness Center, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5417 Johnson Dr, Mission, KS 66205 Phone: 816-841-4865 Fax: 816-841-4801 |