Basic Information
| Provider Information | |||||||||
| NPI: | 1437312089 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CHRISTIANSEN | ||||||||
| FirstName: | KRIPA | ||||||||
| MiddleName: | PATEL | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | PATEL | ||||||||
| OtherFirstName: | KRIPA | ||||||||
| OtherMiddleName: | JAYANTI | ||||||||
| OtherNamePrefix: | |||||||||
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| OtherCredential: | MD | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | PO BOX 411895 | ||||||||
| Address2: | |||||||||
| City: | KANSAS CITY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 641411895 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9136474100 | ||||||||
| FaxNumber: | 9132582509 | ||||||||
| Practice Location | |||||||||
| Address1: | 9100 W 74TH ST | ||||||||
| Address2: | |||||||||
| City: | SHAWNEE MISSION | ||||||||
| State: | KS | ||||||||
| PostalCode: | 662044004 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9136322230 | ||||||||
| FaxNumber: | 9136322297 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/03/2008 | ||||||||
| LastUpdateDate: | 11/10/2020 | ||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
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| IsSoleProprietor: | N | ||||||||
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| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 11/10/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | P5610 | TX | N | Allopathic & Osteopathic Physicians | Anesthesiology | 207L00000X | 48745 | TN | N | Allopathic & Osteopathic Physicians | Anesthesiology | 207R00000X | 9407015 | KS | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207L00000X | 0441572 | KS | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | 7100213600 | 05 | KY | MEDICAID | P02186493 | 01 | KS | RAILROAD | OTHER | 300578027 | 05 | TN | MEDICAID | 201229890A | 05 | KS | MEDICAID | 200074097 | 05 | MO | MEDICAID |