| Mid America Senior Management Llc | |
|
21107 Donahoo Rd Tonganoxie KS 66086-4153 | |
| (913) 742-4084 | |
| (913) 742-4086 |
| Full Name | Mid America Senior Management Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 21107 Donahoo Rd, Tonganoxie, Kansas |
| Authorized Official Name and Position | Anna Marie Mathes (PRACTICE ADMINISTRATOR) |
| Authorized Official Contact | 9137424084 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mid America Senior Management Llc Po Box 996 Tonganoxie KS 66086-0996 Ph: (913) 742-4084 | Mid America Senior Management Llc 21107 Donahoo Rd Tonganoxie KS 66086-4153 Ph: (913) 742-4084 |
| NPI Number | 1942356977 |
|---|---|
| Provider Enumeration Date | 01/25/2007 |
| Last Update Date | 07/21/2011 |
| Medicare PECOS PAC ID | 6406827435 |
|---|---|
| Medicare Enrollment ID | O20050707000856 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942356977 | NPI | - | NPPES |
| 100347530A | Medicaid | KS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 04-21601 (Kansas) | Primary |
| Provider Name | Roger J Bidwell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669425385 PECOS PAC ID: 1254365612 Enrollment ID: I20050924000194 |
| Provider Name | Kimberly M Buckley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265615504 PECOS PAC ID: 3173681285 Enrollment ID: I20090413000081 |
| Provider Name | Mark I Petersen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881647543 PECOS PAC ID: 9133190168 Enrollment ID: I20120303000026 |
| Provider Name | Timothy Edward Badger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316371198 PECOS PAC ID: 8921234568 Enrollment ID: I20131204000158 |
| Provider Name | Tracy S Alagna |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790060705 PECOS PAC ID: 0446480933 Enrollment ID: I20140228001811 |
| Provider Name | Leslyn Brouillette |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386831626 PECOS PAC ID: 9133217250 Enrollment ID: I20150608000578 |
| Provider Name | Philip B Augustine |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003195215 PECOS PAC ID: 8224357033 Enrollment ID: I20160816000684 |
| Provider Name | Tamra L Huntsman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932512944 PECOS PAC ID: 4183842073 Enrollment ID: I20180814002118 |
| Provider Name | Nana Amma Asante |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932705647 PECOS PAC ID: 2860891140 Enrollment ID: I20210519002161 |
| Provider Name | Joanna Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942718358 PECOS PAC ID: 8628333218 Enrollment ID: I20210720003905 |
Unified School District No. 464 Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 330 East 24/40 Hwy, Tonganoxie, KS 66086 Phone: 913-369-2183 Fax: 913-845-3629 | |
Tonganoxie Family Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 508 E 4th St, Tonganoxie, KS 66086 Phone: 913-369-2353 Fax: 913-845-2258 | |
Lmh Health Primary Care - Tonganoxie Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 410 Woodfield Dr, Tonganoxie, KS 66086 Phone: 785-505-5400 Fax: 785-505-5272 | |
Mid America Senior Management Aco Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 21107 Donahoo Rd, Tonganoxie, KS 66086 Phone: 913-742-4084 | |
Family Practice Of Tonganoxie Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 410 Woodfield, Tonganoxie, KS 66086 Phone: 913-845-8400 |