Family Care Of E. Jackson County Llc | |
725 Nw State Route 7 Ste B Blue Springs MO 64014-2426 | |
(816) 229-8187 | |
Not Available |
Full Name | Family Care Of E. Jackson County Llc |
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Speciality | Family Medicine |
Location | 725 Nw State Route 7 Ste B, Blue Springs, Missouri |
Authorized Official Name and Position | Daniel Sykes (VICE PRESIDENT) |
Authorized Official Contact | 8163637303 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Family Care Of E. Jackson County Llc 2000 Health Park Dr Brentwood TN 37027-4525 Ph: (615) 372-5426 | Family Care Of E. Jackson County Llc 725 Nw State Route 7 Ste B Blue Springs MO 64014-2426 Ph: (816) 229-8187 |
NPI Number | 1326094632 |
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Provider Enumeration Date | 05/26/2006 |
Last Update Date | 03/19/2020 |
Medicare PECOS PAC ID | 8426068693 |
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Medicare Enrollment ID | O20060502000852 |
Identifier | Type | State | Issuer |
---|---|---|---|
1326094632 | NPI | - | NPPES |
100452280A | Medicaid | KS | |
506899004 | Medicaid | MO | |
20051024 | Other | KS | BCBS OF KANSAS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Sandra L Mccormick |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1942264718 PECOS PAC ID: 1850355850 Enrollment ID: I20041118000956 |
Provider Name | Karmel L Carothers |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1427006543 PECOS PAC ID: 5991898322 Enrollment ID: I20070830000590 |
Provider Name | Pamela S Maben |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1083609077 PECOS PAC ID: 9537242813 Enrollment ID: I20080208000518 |
Provider Name | Jennifer J Patterson |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1083873558 PECOS PAC ID: 0042388514 Enrollment ID: I20081010000295 |
Provider Name | Bruce D Scully |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1366437972 PECOS PAC ID: 5890825954 Enrollment ID: I20100616000404 |
Provider Name | Virginia Robine |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1144254582 PECOS PAC ID: 5698713006 Enrollment ID: I20100915000227 |
Provider Name | Megan K Pollema |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1407270085 PECOS PAC ID: 4284865510 Enrollment ID: I20140328001892 |
Provider Name | Rutendo Kamudzandu |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1699195602 PECOS PAC ID: 0143444182 Enrollment ID: I20140613001921 |
Provider Name | Amy Rieder |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1679968002 PECOS PAC ID: 7719205913 Enrollment ID: I20150910002574 |
Provider Name | Simon Kinuthia |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1184269532 PECOS PAC ID: 4981039146 Enrollment ID: I20200115002640 |
Provider Name | Huong T Nguyen |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1306232400 PECOS PAC ID: 6406158930 Enrollment ID: I20200413003106 |
Provider Name | Gretchen R Stokes |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1649666546 PECOS PAC ID: 7517269798 Enrollment ID: I20200430002058 |
Provider Name | Bryan Matthew Kaplan |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1841911310 PECOS PAC ID: 3173993896 Enrollment ID: I20221221001049 |
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