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721 N 31st St Ste 101 Kansas City KS 66102-3972 | |
| (913) 621-0074 | |
| (913) 621-1996 |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 721 N 31st St Ste 101, Kansas City, Kansas |
| Authorized Official Name and Position | Geofrey Kigenyi (CEO) |
| Authorized Official Contact | 9136210074 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
721 N 31st St Ste 101 Kansas City KS 66102-3972 Ph: (913) 621-0074 | 721 N 31st St Ste 101 Kansas City KS 66102-3972 Ph: (913) 621-0074 |
| NPI Number | 1609879063 |
|---|---|
| Provider Enumeration Date | 05/31/2005 |
| Last Update Date | 08/29/2023 |
| Medicare PECOS PAC ID | 6204869696 |
|---|---|
| Medicare Enrollment ID | O20050915000930 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609879063 | NPI | - | NPPES |
| 504478009 | Medicaid | MO | |
| 100454840A | Medicaid | KS |
| Provider Name | Cynthia L Moore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396748752 PECOS PAC ID: 6709819196 Enrollment ID: I20050916000847 |
| Provider Name | Thomas R Kreamer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831190511 PECOS PAC ID: 8628069515 Enrollment ID: I20051101001021 |
| Provider Name | Joyce L Simon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588651947 PECOS PAC ID: 5597764605 Enrollment ID: I20061218000338 |
| Provider Name | Nicholas Joseph Michalski |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184783326 PECOS PAC ID: 6305974577 Enrollment ID: I20100507000733 |
| Provider Name | Victoria C Mwarey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073286746 PECOS PAC ID: 9931597457 Enrollment ID: I20220110000922 |
| Provider Name | Marcela Morales |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285392423 PECOS PAC ID: 3173990983 Enrollment ID: I20221108002902 |
| Provider Name | Katie Beth Leimkuehler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386485464 PECOS PAC ID: 0345772927 Enrollment ID: I20241021003449 |
| Provider Name | Jennifer Thibault |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861258766 PECOS PAC ID: 7416480017 Enrollment ID: I20241104000827 |
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