| Family Health Specialist Of Lee's Summit, Llc | |
|
2000 Se Blue Parkway Suite 270 B Lees Summit MO 64063-4466 | |
| (816) 524-8488 | |
| (816) 524-8118 |
| Full Name | Family Health Specialist Of Lee's Summit, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 2000 Se Blue Parkway, Lees Summit, Missouri |
| Authorized Official Name and Position | James Howard Brown (VICE PRESIDENT) |
| Authorized Official Contact | 6153737600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Health Specialist Of Lee's Summit, Llc 2000 Health Park Dr Brentwood TN 37027-4692 Ph: (615) 373-7406 | Family Health Specialist Of Lee's Summit, Llc 2000 Se Blue Parkway Suite 270 B Lees Summit MO 64063-4466 Ph: (816) 524-8488 |
| NPI Number | 1871540658 |
|---|---|
| Provider Enumeration Date | 05/27/2006 |
| Last Update Date | 01/02/2024 |
| Medicare PECOS PAC ID | 1355324625 |
|---|---|
| Medicare Enrollment ID | O20040608001209 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871540658 | NPI | - | NPPES |
| 509102000 | Medicaid | MO | |
| 200257290A | Medicaid | KS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Todd E Fristo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265427348 PECOS PAC ID: 3577547603 Enrollment ID: I20040616000755 |
| Provider Name | Rachel L Hailey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851386932 PECOS PAC ID: 0547244584 Enrollment ID: I20040616000884 |
| Provider Name | Michelle R Britton-mehlisch |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770538936 PECOS PAC ID: 4183693229 Enrollment ID: I20051206000079 |
| Provider Name | Valerie L Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831462167 PECOS PAC ID: 4082875422 Enrollment ID: I20120502000732 |
| Provider Name | Jay B Patel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710273677 PECOS PAC ID: 6103042908 Enrollment ID: I20140731001920 |
| Provider Name | Jessica L Cline |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831595404 PECOS PAC ID: 0941524565 Enrollment ID: I20150130000259 |
| Provider Name | Amy D Wald |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154781664 PECOS PAC ID: 5799084992 Enrollment ID: I20160421001967 |
| Provider Name | Jared D Beck |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386083186 PECOS PAC ID: 5496987612 Enrollment ID: I20161020001763 |
| Provider Name | Jessie L Davis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275916678 PECOS PAC ID: 1759698327 Enrollment ID: I20181017003197 |
| Provider Name | Jillian D Tyler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720508021 PECOS PAC ID: 3072882836 Enrollment ID: I20200727002315 |
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