MEDICARE: DR. THOMAS PATRICK MCNERNEY D.C.

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	111N00000X	Chiropractor	2000167943	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	DE870005	OTHER	MO	EMPLOYER NUMBER
2	29808015	OTHER	MO	BLUE CROSS BLUE SHIELD
3	18104711	OTHER	MO	MO TAX NUMBER

General Provider Information

NPI Number	:	1386852127
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS PATRICK MCNERNEY D.C.

Provider Business Mailing Address
First Line	:	1402 NW VIVION RD
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64118-4555
Country	:	US
Telephone Number	:	816-746-9045
Fax Number	:	816-734-9035

Provider Business Practice Location Address
First Line	:	1402 NW VIVION RD
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64118-4555
Country	:	US
Telephone Number	:	816-746-9045
Fax Number	:	816-734-9035

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/17/2007
Last Update Date	:	07/08/2007

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