| Midwest Metropolitan Physicians Group Llc | |
|
2340 E Meyer Blvd Ste 640 Kansas City MO 64132-1110 | |
| (816) 523-7000 | |
| Not Available |
| Full Name | Midwest Metropolitan Physicians Group Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2340 E Meyer Blvd Ste 640, Kansas City, Missouri |
| Authorized Official Name and Position | Nicholas Wadlington (VICE PRESIDENT) |
| Authorized Official Contact | 9724019807 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Midwest Metropolitan Physicians Group Llc 2000 Health Park Dr Brentwood TN 37027-4525 Ph: (615) 373-7406 | Midwest Metropolitan Physicians Group Llc 2340 E Meyer Blvd Ste 640 Kansas City MO 64132-1110 Ph: (816) 523-7000 |
| NPI Number | 1851341440 |
|---|---|
| Provider Enumeration Date | 05/12/2006 |
| Last Update Date | 05/03/2024 |
| Medicare PECOS PAC ID | 3971490038 |
|---|---|
| Medicare Enrollment ID | O20040303000091 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851341440 | NPI | - | NPPES |
| 507879104 | Medicaid | MO | |
| 100453720A | Medicaid | KS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Philip F Khoury |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1710974076 PECOS PAC ID: 3870544992 Enrollment ID: I20050207000458 |
| Provider Name | Shanika R Taylor Fields |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780941088 PECOS PAC ID: 2264695253 Enrollment ID: I20120601000279 |
| Provider Name | Trace Yule |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720586621 PECOS PAC ID: 0749541324 Enrollment ID: I20180222000121 |
| Provider Name | Simeon King |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1568841922 PECOS PAC ID: 6800199001 Enrollment ID: I20191008000791 |
| Provider Name | Anthony Ceman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1598127045 PECOS PAC ID: 4486941283 Enrollment ID: I20200629000597 |
| Provider Name | Rachel Ruth Dunston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083383087 PECOS PAC ID: 6103224175 Enrollment ID: I20211005001964 |
| Provider Name | Christopher Dao |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1184118960 PECOS PAC ID: 3173872884 Enrollment ID: I20221014000999 |
| Provider Name | Connie Harrington |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518575893 PECOS PAC ID: 8426478884 Enrollment ID: I20230901001431 |
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