Healthcare Provider Details

I. General information

NPI: 1609842285
Provider Name (Legal Business Name): MERCY KANSAS COMMUNITIES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2006
Last Update Date: 04/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 W LAUREL ST
INDEPENDENCE KS
67301-3211
US

IV. Provider business mailing address

PO BOX 845
INDEPENDENCE KS
67301-0845
US

V. Phone/Fax

Practice location:
  • Phone: 620-332-3280
  • Fax: 620-332-3281
Mailing address:
  • Phone: 620-332-3280
  • Fax: 620-332-3281

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number05-30514
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number04-28955
License Number StateKS
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number04-28411
License Number StateKS
# 4
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number05-29688
License Number StateKS
# 5
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number05-31740
License Number StateKS
# 6
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number04-28955
License Number StateKS
# 7
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number04-28411
License Number StateKS
# 8
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number05-31491
License Number StateKS
# 9
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number04-25344
License Number StateKS

VIII. Authorized Official

Name: RITA L TAYLOR
Title or Position: DIRECTOR
Credential:
Phone: 620-332-3217