Healthcare Provider Details

I. General information

NPI: 1700703113
Provider Name (Legal Business Name): KANSAS CITY PAIN & SPINE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12208 W 87TH STREET PKWY STE 180
LENEXA KS
66215-2896
US

IV. Provider business mailing address

12208 W 87TH STREET PKWY STE 180
LENEXA KS
66215-2896
US

V. Phone/Fax

Practice location:
  • Phone: 913-358-9738
  • Fax: 913-358-8809
Mailing address:
  • Phone: 913-358-9738
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State

VIII. Authorized Official

Name: GRANT JAMESON
Title or Position: PHYSICIAN OWNER
Credential:
Phone: 913-358-9738