Healthcare Provider Details

I. General information

NPI: 1578968368
Provider Name (Legal Business Name): PARTNERS IN REHAB MEDICINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2014
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10985 CODY ST STE 115
OVERLAND PARK KS
66210-1224
US

IV. Provider business mailing address

10985 CODY ST STE 115
OVERLAND PARK KS
66210-1224
US

V. Phone/Fax

Practice location:
  • Phone: 816-444-1777
  • Fax: 816-333-3277
Mailing address:
  • Phone: 816-444-1777
  • Fax: 816-333-3277

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: ANDREA S WILDMAN
Title or Position: OFFICE MANAGER
Credential:
Phone: 816-444-1777