| Duchesne Clinic | |
|
636 Tauromee Ave Kansas City KS 66101-3042 | |
| (913) 321-2626 | |
| (913) 321-2651 |
| Full Name | Duchesne Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 636 Tauromee Ave, Kansas City, Kansas |
| Authorized Official Name and Position | George M. Noonan (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 9133212626 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Duchesne Clinic 636 Tauromee Ave Kansas City KS 66101-3042 Ph: (913) 321-2626 | Duchesne Clinic 636 Tauromee Ave Kansas City KS 66101-3042 Ph: (913) 321-2626 |
| NPI Number | 1770790321 |
|---|---|
| Provider Enumeration Date | 05/16/2007 |
| Last Update Date | 11/10/2016 |
| Medicare PECOS PAC ID | 1658651252 |
|---|---|
| Medicare Enrollment ID | O20161216000230 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770790321 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | (* (Not Available)) | Primary |
| Provider Name | Joann Peterson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013070390 PECOS PAC ID: 1850391210 Enrollment ID: I20070109000116 |
| Provider Name | Jana Zaudke |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558403717 PECOS PAC ID: 0244381507 Enrollment ID: I20090625000596 |
| Provider Name | Sarah A. Payne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851833347 PECOS PAC ID: 9638458383 Enrollment ID: I20161121000456 |
| Provider Name | Jennifer Anne Zerr |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942498571 PECOS PAC ID: 0143558676 Enrollment ID: I20190822000394 |
| Provider Name | Deste D Baptiste |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639638125 PECOS PAC ID: 4981936473 Enrollment ID: I20191104000548 |
| Provider Name | Janelle Riley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235578964 PECOS PAC ID: 0840593737 Enrollment ID: I20230502000825 |
| Provider Name | Sylvia Goodloe |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932815727 PECOS PAC ID: 7315305828 Enrollment ID: I20230615000715 |
| Provider Name | Leigh Christine Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568195816 PECOS PAC ID: 9234587486 Enrollment ID: I20231128002542 |
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