| Kansas City Care Clinic | |
|
3515 Broadway Blvd Kansas City MO 64111 | |
| (816) 753-5144 | |
| Not Available |
| Full Name | Kansas City Care Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 3515 Broadway Blvd, Kansas City, Missouri |
| Authorized Official Name and Position | Thomas Wilson Franklin (PRESIDENT AND CEO) |
| Authorized Official Contact | 8167772763 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kansas City Care Clinic 3515 Broadway Blvd Kansas City MO 64111-2501 Ph: (816) 753-5144 | Kansas City Care Clinic 3515 Broadway Blvd Kansas City MO 64111 Ph: (816) 753-5144 |
| NPI Number | 1215273388 |
|---|---|
| Provider Enumeration Date | 12/18/2012 |
| Last Update Date | 06/23/2023 |
| Medicare PECOS PAC ID | 9335386168 |
|---|---|
| Medicare Enrollment ID | O20130514000624 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215273388 | NPI | - | NPPES |
| 500029243 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Dsjon Latrice Thomas |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1518294420 PECOS PAC ID: 2365584273 Enrollment ID: I20100114000731 |
| Provider Name | Craig A Dietz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740247097 PECOS PAC ID: 1153568993 Enrollment ID: I20130514000703 |
| Provider Name | Blair A Thedinger |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750606042 PECOS PAC ID: 4082884218 Enrollment ID: I20131123000033 |
| Provider Name | Michelle Annette Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982097275 PECOS PAC ID: 3072832807 Enrollment ID: I20150430000339 |
| Provider Name | Audrey Renee Lasley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083070973 PECOS PAC ID: 4486935541 Enrollment ID: I20170103001507 |
| Provider Name | Lydia M Madruga |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912103003 PECOS PAC ID: 3577844604 Enrollment ID: I20170104002020 |
| Provider Name | Michelle Renee Goss |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831585355 PECOS PAC ID: 8123309978 Enrollment ID: I20170110001547 |
| Provider Name | Steve E Agocs |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1851405575 PECOS PAC ID: 5496046989 Enrollment ID: I20180227001717 |
| Provider Name | Ryan J Stokes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073909966 PECOS PAC ID: 2961704861 Enrollment ID: I20180731001512 |
| Provider Name | Anand N Rajpara |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1639494198 PECOS PAC ID: 2668699406 Enrollment ID: I20181026001159 |
| Provider Name | Benjamin Michael Grin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922489145 PECOS PAC ID: 6002102076 Enrollment ID: I20190814000340 |
| Provider Name | Fatima Mirza |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1023195229 PECOS PAC ID: 5991034118 Enrollment ID: I20190912001035 |
| Provider Name | George Yeung-fwu Chou |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1861841660 PECOS PAC ID: 0143551507 Enrollment ID: I20191016001210 |
| Provider Name | Mallory Schneider |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649848516 PECOS PAC ID: 0840685327 Enrollment ID: I20220318002285 |
| Provider Name | Kristine Cody |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1740442243 PECOS PAC ID: 5395149140 Enrollment ID: I20220525002071 |
| Provider Name | Nghi Chau |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1538803242 PECOS PAC ID: 1658730635 Enrollment ID: I20230710000227 |
| Provider Name | Jessica Adrienne Axmear |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740857887 PECOS PAC ID: 0345601233 Enrollment ID: I20230725000654 |
| Provider Name | Suzie Kelley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376269472 PECOS PAC ID: 2264893676 Enrollment ID: I20230802000579 |
| Provider Name | Carlos Criss |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1851969539 PECOS PAC ID: 0244691590 Enrollment ID: I20230802002523 |
| Provider Name | Helen Elizabeth Miller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356038038 PECOS PAC ID: 2860832078 Enrollment ID: I20240503002296 |
| Provider Name | Stacey R Bosch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003220245 PECOS PAC ID: 0941657456 Enrollment ID: I20240803000349 |
Plaza Primary Care And Geriatrics Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4440 Broadway, Kansas City, MO 64111 Phone: 816-561-9200 Fax: 816-561-5766 | |
Bannister Internal Medicine Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 9520 James A Reed Rd, Suite B, Kansas City, MO 64134 Phone: 816-599-6317 Fax: 816-599-6319 | |
Elevating Care Clinic, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2340 E. Meyer Blvd, 208, Kansas City, MO 64132 Phone: 816-665-6124 | |
Gateway Spine And Joint Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 800 W 47th St Ste 514, Kansas City, MO 64112 Phone: 816-216-7054 Fax: 816-216-6010 | |
Midwest Neurosurgery Associates, Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6420 Prospect Ave, Suite T411, Kansas City, MO 64132 Phone: 816-363-2500 Fax: 816-363-8741 | |
James E Gracheck, D O P C Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 106 W 72nd St, Kansas City, MO 64114 Phone: 816-444-0025 Fax: 816-444-0007 | |
Medstaffpc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2360 Armour Rd, Kansas City, MO 64116 Phone: 816-214-6852 Fax: 539-777-2506 |