MEDICARE: REBECCA L SHRIVER 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
1	207RP1001X	Pulmonary Disease Physician	108392	MO
2	207RP1001X	Pulmonary Disease Physician	0428721	KS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	104541	OTHER	KS	BCBS KS
3	29380026	OTHER	MO	BCBS KC
4	29380036	OTHER		BCBS KC
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1740282516
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA L SHRIVER M.D.

Provider Business Mailing Address
First Line	:	901 E 104TH ST
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64131-4517
Country	:	US
Telephone Number	:	816-502-8752
Fax Number	:	816-932-9670

Provider Business Practice Location Address
First Line	:	4321 WASHINGTON ST
Second Line	:	SUITE 6000
City	:	KANSAS CITY
State	:	MO
Zip	:	64111-5961
Country	:	US
Telephone Number	:	816-756-2255
Fax Number	:	816-931-4080

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

Provider Enumeration Date	:	08/11/2005
Last Update Date	:	08/17/2016

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Directions to “ REBECCA L SHRIVER M.D.” Practice Location

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