| Centerwell Senior Primary Care (mo) Pc | |
|
301 E Armour Blvd Ste 2east Kansas City MO 64111-1245 | |
| (816) 394-2082 | |
| (855) 446-7255 |
| Full Name | Centerwell Senior Primary Care (mo) Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 301 E Armour Blvd Ste 2east, Kansas City, Missouri |
| Authorized Official Name and Position | Angie Martinez (SENIOR CREDENTIALING PROFESSIONAL) |
| Authorized Official Contact | 4074477120 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Centerwell Senior Primary Care (mo) Pc 6101 Blue Lagoon Dr Ste 200 Miami FL 33126-3168 Ph: (305) 500-2000 | Centerwell Senior Primary Care (mo) Pc 301 E Armour Blvd Ste 2east Kansas City MO 64111-1245 Ph: (816) 394-2082 |
| NPI Number | 1639692098 |
|---|---|
| Provider Enumeration Date | 07/18/2017 |
| Last Update Date | 08/19/2024 |
| Medicare PECOS PAC ID | 1254744469 |
|---|---|
| Medicare Enrollment ID | O20210107002098 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639692098 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 208D00000X | General Practice | (* (Not Available)) | Secondary |
| Provider Name | Sequita Richardson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356312458 PECOS PAC ID: 0749270213 Enrollment ID: I20040517000149 |
| Provider Name | Katrina D Powers |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588622153 PECOS PAC ID: 9335102409 Enrollment ID: I20041110000397 |
| Provider Name | Faisal Nazir Ahmad |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912090879 PECOS PAC ID: 9537180922 Enrollment ID: I20051213000631 |
| Provider Name | Kenneth Lawrence Taylor-butler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568462992 PECOS PAC ID: 5698799690 Enrollment ID: I20060117001133 |
| Provider Name | Carol A Harrington |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124018437 PECOS PAC ID: 4385647163 Enrollment ID: I20060816000502 |
| Provider Name | Scott E Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093714933 PECOS PAC ID: 9739188152 Enrollment ID: I20061213000274 |
| Provider Name | Candice Mcgowan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639403876 PECOS PAC ID: 3173669785 Enrollment ID: I20091013000599 |
| Provider Name | Vinod Velakaturi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235124298 PECOS PAC ID: 7810025715 Enrollment ID: I20100513001056 |
| Provider Name | Anthony Gutierrez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558368381 PECOS PAC ID: 6800910464 Enrollment ID: I20100902001054 |
| Provider Name | Nancy Stepanek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861624843 PECOS PAC ID: 3476745746 Enrollment ID: I20101005000419 |
| Provider Name | Cristina M Ramirez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720361306 PECOS PAC ID: 1254226442 Enrollment ID: I20130806000441 |
| Provider Name | Allison L Medlin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508018128 PECOS PAC ID: 6709058134 Enrollment ID: I20150706000046 |
| Provider Name | Keri J Sutter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457731309 PECOS PAC ID: 3476700493 Enrollment ID: I20150710001987 |
| Provider Name | Shanna Rose Ripley |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184985921 PECOS PAC ID: 8123241270 Enrollment ID: I20150825002768 |
| Provider Name | Katherine D Easley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336547793 PECOS PAC ID: 6709100753 Enrollment ID: I20151112001262 |
| Provider Name | Stephanie M Ikeme |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790921914 PECOS PAC ID: 5395999767 Enrollment ID: I20160728001668 |
| Provider Name | Sarah Doll |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164969143 PECOS PAC ID: 4587949631 Enrollment ID: I20170403000100 |
| Provider Name | Dirk R Thompson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548277353 PECOS PAC ID: 1254383995 Enrollment ID: I20190311002445 |
| Provider Name | William Stueve |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225016462 PECOS PAC ID: 2466644893 Enrollment ID: I20200318001352 |
| Provider Name | Anthonia Egbedeju |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568758829 PECOS PAC ID: 7719156934 Enrollment ID: I20200825000369 |
| Provider Name | Thuytien Le |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386984045 PECOS PAC ID: 2062650187 Enrollment ID: I20210720004057 |
| Provider Name | Lauren Kay Rojas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578041125 PECOS PAC ID: 6709128390 Enrollment ID: I20211013001320 |
| Provider Name | Marianne Cecille Ray |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457580060 PECOS PAC ID: 4486877313 Enrollment ID: I20220419001211 |
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