| Nelopher Medical Group | |
|
14433 W 86th Ter Lenexa KS 66215-4178 | |
| (913) 634-3540 | |
| (913) 825-6358 |
| Full Name | Nelopher Medical Group |
|---|---|
| Speciality | Internal Medicine |
| Location | 14433 W 86th Ter, Lenexa, Kansas |
| Authorized Official Name and Position | Waddah Y Ghosheh (PRACTICE MANAGER) |
| Authorized Official Contact | 9136343540 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Nelopher Medical Group 9506 W 149th Ter Overland Park KS 66221-8202 Ph: (913) 302-5188 | Nelopher Medical Group 14433 W 86th Ter Lenexa KS 66215-4178 Ph: (913) 634-3540 |
| NPI Number | 1740641455 |
|---|---|
| Provider Enumeration Date | 03/09/2016 |
| Last Update Date | 03/09/2016 |
| Medicare PECOS PAC ID | 2466745906 |
|---|---|
| Medicare Enrollment ID | O20160721001457 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740641455 | NPI | - | NPPES |
| 1023159522 | Other | KS | INDIVIDUAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 0431411 (Kansas) | Primary |
| Provider Name | Nelopher Hathiary |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023159522 PECOS PAC ID: 3971529017 Enrollment ID: I20051018001186 |
| Provider Name | Lilian Barnes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104458116 PECOS PAC ID: 9032549027 Enrollment ID: I20200414003656 |
| Provider Name | Courtney Kelso |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780268862 PECOS PAC ID: 1153727300 Enrollment ID: I20210914000377 |
| Provider Name | Maya Dolnik |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346911526 PECOS PAC ID: 2668870726 Enrollment ID: I20211005000987 |
| Provider Name | Papri Barman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417694902 PECOS PAC ID: 4082090204 Enrollment ID: I20220926001660 |
| Provider Name | Amanda Stanley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346946639 PECOS PAC ID: 7113392242 Enrollment ID: I20230403002513 |
| Provider Name | Rebekah Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730883778 PECOS PAC ID: 0547622037 Enrollment ID: I20230815004030 |
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