Healthcare Provider Details

I. General information

NPI: 1972427060
Provider Name (Legal Business Name): LENEXA AMBULATORY SURGERY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16801 W 116TH ST
LENEXA KS
66219-9603
US

IV. Provider business mailing address

16801 W 116TH ST
LENEXA KS
66219-9603
US

V. Phone/Fax

Practice location:
  • Phone: 816-452-4488
  • Fax:
Mailing address:
  • Phone: 816-452-4488
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: KENDRA PEARSON
Title or Position: AUTHORIZED OFFICIAL
Credential: DC
Phone: 816-916-0001