| Mid-america Sports Medicine And Wellness | |
|
19550 E 39th St S Suite 419 Independence MO 64057-2303 | |
| (816) 795-8200 | |
| (816) 795-7735 |
| Full Name | Mid-america Sports Medicine And Wellness |
|---|---|
| Speciality | Family Medicine |
| Location | 19550 E 39th St S, Independence, Missouri |
| Authorized Official Name and Position | Patrick J Kueny (VICE PRESIDENT) |
| Authorized Official Contact | 8165084090 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mid-america Sports Medicine And Wellness 19550 E 39th St S Suite 419 Independence MO 64057-2303 Ph: (816) 795-8200 | Mid-america Sports Medicine And Wellness 19550 E 39th St S Suite 419 Independence MO 64057-2303 Ph: (816) 795-8200 |
| NPI Number | 1841462314 |
|---|---|
| Provider Enumeration Date | 03/25/2008 |
| Last Update Date | 12/16/2009 |
| Medicare PECOS PAC ID | 3173685948 |
|---|---|
| Medicare Enrollment ID | O20090105000190 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841462314 | NPI | - | NPPES |
| 200584160 B | Medicaid | KS | |
| 200584160 A | Medicaid | KS | |
| 1841462314 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QS0010X | Family Medicine - Sports Medicine | (* (Not Available)) | Primary |
| 208M00000X | Hospitalist | (* (Not Available)) | Secondary |
| Provider Name | Lori A Boyajian-oneill |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225077522 PECOS PAC ID: 6406824739 Enrollment ID: I20040923000614 |
| Provider Name | Hameed Ahmad |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144437310 PECOS PAC ID: 7810088390 Enrollment ID: I20070813000653 |
| Provider Name | David D Dyck |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649231051 PECOS PAC ID: 7214099092 Enrollment ID: I20090105000256 |
| Provider Name | Peninnah M Mutungi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720251945 PECOS PAC ID: 4183793433 Enrollment ID: I20100802000034 |
| Provider Name | Dacia Jonell Murdock |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730318783 PECOS PAC ID: 6305099805 Enrollment ID: I20130118000163 |
| Provider Name | Nikki Bajaj |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467893917 PECOS PAC ID: 0547494213 Enrollment ID: I20140207001512 |
Noland Family Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 514 S Noland Rd, Suite 130, Independence, MO 64050 Phone: 816-254-1781 Fax: 816-254-2182 | |
Medbasics Missouri Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4201 S Noland Rd, Independence, MO 64055 Phone: 816-373-9901 Fax: 816-373-9905 | |
Independence Group Health, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 19045 E Valley View Pkwy Ste G, Independence, MO 64055 Phone: 281-429-8526 | |
Swope Health East Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 17844 East 23rd Street, Independence, MO 64057 Phone: 816-922-1000 | |
P&c Healthcare Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 19600 E 39th St S, Independence, MO 64057 Phone: 913-222-9779 | |
Jackson County Medical Group Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 17221 E 23rd St S, Suite 100, Independence, MO 64057 Phone: 816-350-0005 | |
Kc Core Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 19550 E 39th St S, Suite 235, Independence, MO 64057 Phone: 816-795-5300 Fax: 816-795-5305 |