Healthcare Provider Details

I. General information

NPI: 1376986901
Provider Name (Legal Business Name): JAMES BRIAN SMITH D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2013
Last Update Date: 09/16/2025
Certification Date: 09/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

815 S CLAIRBORNE RD STE 150
OLATHE KS
66062-1930
US

IV. Provider business mailing address

904 WOLLARD BLVD
RICHMOND MO
64085-2229
US

V. Phone/Fax

Practice location:
  • Phone: 913-884-1924
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2014030563
License Number StateMO
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number05-39263
License Number StateKS
# 4
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number9571555
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: