| Doc Shop, Pa | |
| 
					5407 Johnson Dr Mission KS 66205-2912  | |
| (913) 362-0220 | |
| (913) 362-0440 | 
| Full Name | Doc Shop, Pa | 
|---|---|
| Speciality | Family Medicine | 
| Location | 5407 Johnson Dr, Mission, Kansas | 
| Authorized Official Name and Position | Sharon D. Lee (PRESIDENT) | 
| Authorized Official Contact | 9133620220 | 
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Doc Shop, Pa 5407 Johnson Dr Mission KS 66205-2912 Ph: (913) 362-0220  | Doc Shop, Pa 5407 Johnson Dr Mission KS 66205-2912 Ph: (913) 362-0220  | 
| NPI Number | 1275139305 | 
|---|---|
| Provider Enumeration Date | 12/04/2020 | 
| Last Update Date | 11/02/2022 | 
| Medicare PECOS PAC ID | 6002229697 | 
|---|---|
| Medicare Enrollment ID | O20201228000912 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1275139305 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary | 
| Provider Name | Sharon D Lee | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1154439081 PECOS PAC ID: 7214004118 Enrollment ID: I20080918000361  | 
| Provider Name | Robert E Jevons | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1386704732 PECOS PAC ID: 1658402367 Enrollment ID: I20100624000363  | 
| Provider Name | Kenyada J Gilbert | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1386200442 PECOS PAC ID: 4284006099 Enrollment ID: I20230203001469  | 
| Provider Name | Francina Whitley | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1467010298 PECOS PAC ID: 4284055682 Enrollment ID: I20240618000083  | 
Serc Rehabilitation Partners, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5799 Broadmoor St Ste 300, Mission, KS 66202 Phone: 913-384-5600 Fax: 913-384-0719  | |
Prime Care Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5417 Johnson Dr, Mission, KS 66205 Phone: 913-261-9479  | |
Kc Wellness Center, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5417 Johnson Dr, Mission, KS 66205 Phone: 816-841-4865 Fax: 816-841-4801  | |
Kansas Injury Partners Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6700 Squibb Rd Ste 105, Mission, KS 66202 Phone: 913-379-6604  |