Basic Information
| Provider Information | |||||||||
| NPI: | 1497182539 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | KANSAS CITY PHYSICIAN PARTNERS, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4440 BROADWAY BLVD | ||||||||
| Address2: | |||||||||
| City: | KANSAS CITY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 641113315 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8165310930 | ||||||||
| FaxNumber: | 8167532671 | ||||||||
| Practice Location | |||||||||
| Address1: | 4440 BROADWAY ST | ||||||||
| Address2: | |||||||||
| City: | KANSAS CITY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 641113315 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8165619200 | ||||||||
| FaxNumber: | 8165615766 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/03/2013 | ||||||||
| LastUpdateDate: | 03/20/2021 | ||||||||
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| AuthorizedOfficialLastName: | WARNER | ||||||||
| AuthorizedOfficialFirstName: | ANN | ||||||||
| AuthorizedOfficialMiddleName: | E | ||||||||
| AuthorizedOfficialTitleorPosition: | PARTNER/PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8165310930 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 03/20/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 364SA2200X | 5374362022 | KS | N | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | Adult Health | 207KA0200X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Allergy & Immunology | Allergy | 207RG0300X | 04-22651 | KS | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Geriatric Medicine | 207RR0500X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology |
ID Information
| ID | Type | State | Issuer | Description | 1013959022 | 01 | MO | NPPES | OTHER | 1740247873 | 01 | MO | NPPES | OTHER |