MEDICARE: KANSAS CITY SURGICAL ASSISTING, INC.

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
1	163WR0006X	Registered Nurse First Assistant	146414	MO

General Provider Information

NPI Number	:	1164630521
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KANSAS CITY SURGICAL ASSISTING, INC.

Provider Business Mailing Address
First Line	:	18100 E 215TH ST
Second Line	:
City	:	PECULIAR
State	:	MO
Zip	:	64078-9200
Country	:	US
Telephone Number	:	816-304-7107
Fax Number	:	816-380-6529

Provider Business Practice Location Address
First Line	:	18100 E 215TH ST
Second Line	:
City	:	PECULIAR
State	:	MO
Zip	:	64078-9200
Country	:	US
Telephone Number	:	816-304-7107
Fax Number	:	816-380-6529

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. LINDA G. FREY
Credential	:	RNFA
Telephone Number	:	816-304-7107

Provider Enumeration Date	:	05/18/2007
Last Update Date	:	08/22/2020

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