| Jcmhc Chronic Care Clinic | |
|
6440 Nieman Rd Shawnee KS 66203-3326 | |
| (913) 826-4200 | |
| Not Available |
| Full Name | Jcmhc Chronic Care Clinic |
|---|---|
| Speciality | General Practice |
| Location | 6440 Nieman Rd, Shawnee, Kansas |
| Authorized Official Name and Position | Lydia Longoria (QI REPRESENTATIVE) |
| Authorized Official Contact | 9138264200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jcmhc Chronic Care Clinic 6000 Lamar Ave Ste 130 Mission KS 66202-3234 Ph: () - | Jcmhc Chronic Care Clinic 6440 Nieman Rd Shawnee KS 66203-3326 Ph: (913) 826-4200 |
| NPI Number | 1548989262 |
|---|---|
| Provider Enumeration Date | 08/25/2022 |
| Last Update Date | 07/18/2023 |
| Medicare PECOS PAC ID | 1951760032 |
|---|---|
| Medicare Enrollment ID | O20230707001309 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548989262 | NPI | - | NPPES |
| Provider Name | Carla Shepard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245747005 PECOS PAC ID: 0143572073 Enrollment ID: I20181004000623 |
| Provider Name | Rachel Lyn Itkonen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689327066 PECOS PAC ID: 9133514755 Enrollment ID: I20240604000863 |
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