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NPI Code Detail

MEDICARE: DR. LISA MARIE HERMES M.D.

MEDICARE: DR. LISA MARIE HERMES M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208100000XPhysical Medicine & Rehabilitation Physician0429105KS
2208100000XPhysical Medicine & Rehabilitation Physician2001006202MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1003818345
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LISA MARIE HERMES M.D.
Provider Business Mailing Address
First Line : 4401 WORNALL RD
Second Line : REHAB PHYSICIANS MEDICAL GROUP, MAIN 4
City : KANSAS CITY
State : MO
Zip : 64111-3220
Country : US
Telephone Number : 816-932-2020
Fax Number : 816-932-6211
Provider Business Practice Location Address
First Line : 4401 WORNALL RD
Second Line : REHAB PHYSICIANS MEDICAL GROUP, MAIN 4
City : KANSAS CITY
State : MO
Zip : 64111-3220
Country : US
Telephone Number : 816-932-2020
Fax Number : 816-932-6211
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2005
Last Update Date : 10/07/2011

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Directions to “ DR. LISA MARIE HERMES M.D.” Practice Location

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