| The Medical Group Of Kansas City, Llc | |
|
6675 Holmes Rd Suite 550 Kansas City MO 64131-1167 | |
| (816) 363-7710 | |
| (816) 363-8414 |
| Full Name | The Medical Group Of Kansas City, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 6675 Holmes Rd, Kansas City, Missouri |
| Authorized Official Name and Position | Todd Carlon (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 |
|---|---|
| The Medical Group Of Kansas City, Llc Po Box 403453 Atlanta GA 30384-3453 Ph: (816) 363-7710 | The Medical Group Of Kansas City, Llc 6675 Holmes Rd Suite 550 Kansas City MO 64131-1167 Ph: (816) 363-7710 |
| NPI Number | 1407803273 |
|---|---|
| Provider Enumeration Date | 05/27/2006 |
| Last Update Date | 11/01/2013 |
| Medicare PECOS PAC ID | 8921091455 |
|---|---|
| Medicare Enrollment ID | O20040408000248 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407803273 | NPI | - | NPPES |
| 24143031 | Other | MO | BCBS OF KANSAS |
| 100452640B | Medicaid | KS | |
| 501165203 | Medicaid | MO | |
| 100452640A | Medicaid | KS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Maninder Pabla |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952360919 PECOS PAC ID: 1355306234 Enrollment ID: I20041120000200 |
| Provider Name | Douglas J Mckee |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639164221 PECOS PAC ID: 9537168133 Enrollment ID: I20061208000284 |
| Provider Name | Gerald F Williams |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982695987 PECOS PAC ID: 7315077674 Enrollment ID: I20100611000822 |
| Provider Name | Ahmad Al-mubaslat |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1255328738 PECOS PAC ID: 9638073901 Enrollment ID: I20100612000192 |
| Provider Name | Chandrasekhar Chilappa |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1225041221 PECOS PAC ID: 2163520529 Enrollment ID: I20101213001142 |
| Provider Name | Kimberly F Nagel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003852187 PECOS PAC ID: 8820127327 Enrollment ID: I20110207000557 |
| Provider Name | Radhika Mathur |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073582268 PECOS PAC ID: 1850315599 Enrollment ID: I20110405000711 |
| Provider Name | Michael B Dahl |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124013297 PECOS PAC ID: 9739285420 Enrollment ID: I20120105000841 |
| Provider Name | Elliott L Franks |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1649265729 PECOS PAC ID: 5597861286 Enrollment ID: I20120105000910 |
| Provider Name | John Paul Armilio |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386873743 PECOS PAC ID: 8426225053 Enrollment ID: I20120121000046 |
| Provider Name | Stephanie A Bailey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477819274 PECOS PAC ID: 8527222389 Enrollment ID: I20120607000593 |
| Provider Name | Andrea M Froese |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952705592 PECOS PAC ID: 7719109180 Enrollment ID: I20141119002252 |
| Provider Name | Randyn A Wertz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003355322 PECOS PAC ID: 3678858974 Enrollment ID: I20170329001644 |
| Provider Name | Lachelle Sherice Dunbar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780187179 PECOS PAC ID: 1254683774 Enrollment ID: I20181011001874 |
| Provider Name | Aaron G Ellison |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730154659 PECOS PAC ID: 2365444320 Enrollment ID: I20181017002475 |
| Provider Name | Kacy S Warner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265997290 PECOS PAC ID: 7719213131 Enrollment ID: I20190723003229 |
| Provider Name | Kenneth Lan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316439169 PECOS PAC ID: 6002214871 Enrollment ID: I20211007003496 |
| Provider Name | Katherine Renee Greub |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407344468 PECOS PAC ID: 3577955160 Enrollment ID: I20220111000956 |
| Provider Name | Emily Marie Milburn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669124459 PECOS PAC ID: 1052705761 Enrollment ID: I20220223000863 |
| Provider Name | Shelby Shanae Luster |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023767811 PECOS PAC ID: 8921474701 Enrollment ID: I20221019001406 |
| Provider Name | Venkata Vamsi Nagineni |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841850518 PECOS PAC ID: 7012384092 Enrollment ID: I20221103001833 |
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