Healthcare Provider Details

I. General information

NPI: 1720142565
Provider Name (Legal Business Name): SHAWNEE MISSION MEDICAL CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2006
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9100 W 74TH ST
MERRIAM KS
66204-4004
US

IV. Provider business mailing address

9100 W 74TH ST
MERRIAM KS
66204-4004
US

V. Phone/Fax

Practice location:
  • Phone: 913-676-2000
  • Fax: 913-676-7571
Mailing address:
  • Phone: 913-676-2000
  • Fax: 913-676-7571

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273R00000X
TaxonomyPsychiatric Hospital Unit
License NumberH046004
License Number StateKS

VIII. Authorized Official

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