| Kc Care Health Center | |
|
3515 Broadway Blvd Kansas City MO 64111 | |
| (816) 753-5144 | |
| Not Available |
| Full Name | Kc Care Health Center |
|---|---|
| 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 |
|---|---|
| Kc Care Health Center 3515 Broadway Blvd Kansas City MO 64111-2501 Ph: (816) 753-5144 | Kc Care Health Center 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 | Nancy Birenboim |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346239100 PECOS PAC ID: 4880587633 Enrollment ID: I20040428001344 |
| Provider Name | Chris W Craemer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073537742 PECOS PAC ID: 9931171196 Enrollment ID: I20040809000578 |
| Provider Name | Robert M Ross |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043233521 PECOS PAC ID: 0244296036 Enrollment ID: I20041203000222 |
| Provider Name | Sarah H Parrott |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1609972959 PECOS PAC ID: 4789610379 Enrollment ID: I20050714000805 |
| Provider Name | Lois J Mckinley |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295774727 PECOS PAC ID: 4486681830 Enrollment ID: I20050718000919 |
| Provider Name | Michael Wayne Cartwright |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1467541276 PECOS PAC ID: 5496755407 Enrollment ID: I20061221000417 |
| Provider Name | Katherine Friedebach |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871537704 PECOS PAC ID: 5799881140 Enrollment ID: I20070502000217 |
| Provider Name | Shahbaz M Khan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1962591313 PECOS PAC ID: 5193809218 Enrollment ID: I20080228000325 |
| Provider Name | Dsjon Latrice Thomas |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1518294420 PECOS PAC ID: 2365584273 Enrollment ID: I20100114000731 |
| Provider Name | Kevin D Treffer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215976972 PECOS PAC ID: 1153457130 Enrollment ID: I20100329001053 |
| Provider Name | Douglas Herriott |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1700885860 PECOS PAC ID: 4486793072 Enrollment ID: I20120330000512 |
| Provider Name | Craig A Dietz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740247097 PECOS PAC ID: 1153568993 Enrollment ID: I20130514000703 |
| Provider Name | Ramon E Newman |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1437259819 PECOS PAC ID: 3476795147 Enrollment ID: I20130808000364 |
| Provider Name | Blair A Thedinger |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750606042 PECOS PAC ID: 4082884218 Enrollment ID: I20131123000033 |
| Provider Name | Muhammad Imran |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1881987071 PECOS PAC ID: 6507085875 Enrollment ID: I20140918001227 |
| Provider Name | Michelle Annette Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982097275 PECOS PAC ID: 3072832807 Enrollment ID: I20150430000339 |
| Provider Name | Noah B Mccarty |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518391481 PECOS PAC ID: 0840590436 Enrollment ID: I20151203003052 |
| Provider Name | Kelsey U Ryan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891138343 PECOS PAC ID: 3870894835 Enrollment ID: I20160909000099 |
| 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 | Susan M Blum Kratky |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215474895 PECOS PAC ID: 6507127834 Enrollment ID: I20180301002839 |
| Provider Name | Maria C Paillaman-bello |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235128703 PECOS PAC ID: 9931145927 Enrollment ID: I20180521002234 |
| Provider Name | Paul B Rotert |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992071393 PECOS PAC ID: 5698080349 Enrollment ID: I20180628000995 |
| Provider Name | Alyssa Baily Sherwood |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1245769801 PECOS PAC ID: 3375899644 Enrollment ID: I20180629001215 |
| Provider Name | Ryan J Stokes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073909966 PECOS PAC ID: 2961704861 Enrollment ID: I20180731001512 |
| Provider Name | Brett Thomas Campbell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407227416 PECOS PAC ID: 8022366244 Enrollment ID: I20180803002987 |
| Provider Name | Sarah Claire Scoggin |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1083100671 PECOS PAC ID: 8426307851 Enrollment ID: I20180820000213 |
| Provider Name | Margaret Lyn Boehm |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1366976862 PECOS PAC ID: 6002167566 Enrollment ID: I20180921001381 |
| Provider Name | Anand N Rajpara |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1639494198 PECOS PAC ID: 2668699406 Enrollment ID: I20181026001159 |
| Provider Name | Brett Chamberlain |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1063895100 PECOS PAC ID: 5597002980 Enrollment ID: I20190123001943 |
| Provider Name | Nidhi Gupta |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1780737627 PECOS PAC ID: 3375841380 Enrollment ID: I20190315001765 |
| Provider Name | Megan Buri |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922462795 PECOS PAC ID: 0840581518 Enrollment ID: I20190522001905 |
| Provider Name | Katherine Anne Dumbell |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1316508732 PECOS PAC ID: 2466789607 Enrollment ID: I20190809001635 |
| Provider Name | Benjamin Michael Grin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922489145 PECOS PAC ID: 6002102076 Enrollment ID: I20190814000340 |
| Provider Name | Shawn Boehm |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1902397250 PECOS PAC ID: 2567719040 Enrollment ID: I20190821000833 |
| Provider Name | Fatima Mirza |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1023195229 PECOS PAC ID: 5991034118 Enrollment ID: I20190912001035 |
| Provider Name | Nicole Danielle Hamilton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417501255 PECOS PAC ID: 5991034738 Enrollment ID: I20190930000536 |
| 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 | Kenneth A Zaremski |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457440513 PECOS PAC ID: 5991765539 Enrollment ID: I20200205000748 |
| Provider Name | Jessica Rimkus Richter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164809380 PECOS PAC ID: 5698077667 Enrollment ID: I20200224000495 |
| Provider Name | Beth Gottstein Thompson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083372635 PECOS PAC ID: 5294126207 Enrollment ID: I20211230001697 |
| Provider Name | Mallory Schneider |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649848516 PECOS PAC ID: 0840685327 Enrollment ID: I20220318002285 |
| Provider Name | Andrew C Medlin |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1851738975 PECOS PAC ID: 4284862996 Enrollment ID: I20220322002124 |
| Provider Name | Yesenia Esperanza Beltran |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245803477 PECOS PAC ID: 4082009162 Enrollment ID: I20220329000217 |
| 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 |
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