| Goppert - Trinity Family Care, Llc | |
|
6675 Holmes Road Suite 360 Kansas City MO 64131-1215 | |
| (816) 276-7600 | |
| (816) 276-7992 |
| Full Name | Goppert - Trinity Family Care, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 6675 Holmes Road, Kansas City, Missouri |
| Authorized Official Name and Position | Mickey Pickler (VP) |
| Authorized Official Contact | 8165084039 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Goppert - Trinity Family Care, Llc 6675 Holmes Road Suite 450 Kansas City MO 64131-1215 Ph: (816) 276-7650 | Goppert - Trinity Family Care, Llc 6675 Holmes Road Suite 360 Kansas City MO 64131-1215 Ph: (816) 276-7600 |
| NPI Number | 1922097013 |
|---|---|
| Provider Enumeration Date | 10/20/2005 |
| Last Update Date | 06/16/2014 |
| Medicare PECOS PAC ID | 8426956681 |
|---|---|
| Medicare Enrollment ID | O20031224000034 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922097013 | NPI | - | NPPES |
| 503959504 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Terry D Suppes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194763524 PECOS PAC ID: 9830174457 Enrollment ID: I20040618001296 |
| Provider Name | Nicholas B Comninellis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215003652 PECOS PAC ID: 7810939741 Enrollment ID: I20050601000448 |
| Provider Name | Gazala Parvin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447242706 PECOS PAC ID: 5890794390 Enrollment ID: I20070523000116 |
| Provider Name | Jennifer A Kelley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710920210 PECOS PAC ID: 0941223309 Enrollment ID: I20070907000108 |
| Provider Name | Gautam J Desai |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881633071 PECOS PAC ID: 5092841072 Enrollment ID: I20100329001019 |
| Provider Name | Kavitha K Arabindoo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083667687 PECOS PAC ID: 3779557236 Enrollment ID: I20100504000457 |
| Provider Name | Melissa L Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659366250 PECOS PAC ID: 9931237740 Enrollment ID: I20100514000135 |
| Provider Name | Revathi N Bhat |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477580918 PECOS PAC ID: 4688862964 Enrollment ID: I20101230000899 |
| Provider Name | Karen Jean Foote |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801872460 PECOS PAC ID: 1850434564 Enrollment ID: I20110816000337 |
| Provider Name | Stephanie A Bailey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477819274 PECOS PAC ID: 8527222389 Enrollment ID: I20120607000593 |
| Provider Name | Rachel K Allen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619400207 PECOS PAC ID: 4385908151 Enrollment ID: I20180502000964 |
| Provider Name | Tricia Lyn Fairchild |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609169499 PECOS PAC ID: 3678719325 Enrollment ID: I20180508000071 |
| Provider Name | Katherine Rose Mcdaniel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831623131 PECOS PAC ID: 0941551154 Enrollment ID: I20180927002284 |
| Provider Name | Anne M Valburg |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659876258 PECOS PAC ID: 8426302902 Enrollment ID: I20181120001106 |
| Provider Name | Brent A. Hrabik |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720008295 PECOS PAC ID: 6901796325 Enrollment ID: I20190305001170 |
| Provider Name | Cristina L Enrique |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528590247 PECOS PAC ID: 6406128057 Enrollment ID: I20211022000585 |
| Provider Name | Ashley L Cefalu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376048900 PECOS PAC ID: 5395089247 Enrollment ID: I20211022001667 |
| Provider Name | Sharon Marie Gustowski |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1285632133 PECOS PAC ID: 3870519077 Enrollment ID: I20230918003871 |
| Provider Name | Drake Alexander Duckworth |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386203560 PECOS PAC ID: 3274961610 Enrollment ID: I20231209000205 |
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