MEDICARE: GREINER ORTHOPEDICS LLC

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	207X00000X	Orthopaedic Surgery Physician	2006015219	MO

General Provider Information

NPI Number	:	1659806453
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GREINER ORTHOPEDICS LLC

Provider Business Mailing Address
First Line	:	4941 NW CANYON RD
Second Line	:
City	:	LEES SUMMIT
State	:	MO
Zip	:	64064-2066
Country	:	US
Telephone Number	:	816-317-5070
Fax Number	:	816-205-8282

Provider Business Practice Location Address
First Line	:	19201 E VALLEY VIEW PKWY STE C
Second Line	:
City	:	INDEPENDENCE
State	:	MO
Zip	:	64055-6913
Country	:	US
Telephone Number	:	816-317-5070
Fax Number	:	855-862-9292

Authorized Official
Title or Position	:	ASSISTANT MANAGER
Name	:	JESSIKA N MILLER
Credential	:
Telephone Number	:	816-647-2251

Provider Enumeration Date	:	04/29/2017
Last Update Date	:	09/19/2024

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