Healthcare Provider Details

I. General information

NPI: 1942155890
Provider Name (Legal Business Name): MEGHAN GRACE GOFF MPAS, PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/04/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16990 W 86TH ST STE 100
LENEXA KS
66219-4506
US

IV. Provider business mailing address

21548 S LACKMAN RD
SPRING HILL KS
66083-3057
US

V. Phone/Fax

Practice location:
  • Phone: 913-676-8400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number15-03239
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: