Healthcare Provider Details

I. General information

NPI: 1790755486
Provider Name (Legal Business Name): JAMES E POWELL MS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2006
Last Update Date: 11/14/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9535 STATE AVE
KANSAS CITY KS
66111-1815
US

IV. Provider business mailing address

8901 W 74TH ST # 150
SHAWNEE MISSION KS
66204-2282
US

V. Phone/Fax

Practice location:
  • Phone: 913-334-5621
  • Fax: 913-384-9612
Mailing address:
  • Phone: 913-384-5880
  • Fax: 913-384-9612

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number802
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number605
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberCE564
License Number StateKS
# 4
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number000397
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: