Healthcare Provider Details

I. General information

NPI: 1194112151
Provider Name (Legal Business Name): BRANDON LEE BARNDS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2015
Last Update Date: 01/18/2022
Certification Date: 01/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10701 NALL AVE STE 200
OVERLAND PARK KS
66211-1358
US

IV. Provider business mailing address

10701 NALL AVE STE 200
OVERLAND PARK KS
66211-1358
US

V. Phone/Fax

Practice location:
  • Phone: 913-381-5225
  • Fax: 913-901-0186
Mailing address:
  • Phone: 913-381-5225
  • Fax: 913-901-0186

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License NumberDR.0064074
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number2021023196
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number04-44686
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: