Healthcare Provider Details

I. General information

NPI: 1770731853
Provider Name (Legal Business Name): SHAWNEE MISSION PRAIRIE STAR SURGERY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2008
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23401 PRAIRIE STAR PKWY STE B200
LENEXA KS
66227-7268
US

IV. Provider business mailing address

7315 E FRONTAGE RD STE 200
MERRIAM KS
66204-1658
US

V. Phone/Fax

Practice location:
  • Phone: 913-676-8550
  • Fax: 913-676-8588
Mailing address:
  • Phone: 913-676-7771
  • Fax: 913-676-7776

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number StateKS

VIII. Authorized Official

Name: STEPHANIE ROSENTRETER
Title or Position: CFO
Credential:
Phone: 620-249-2457