Healthcare Provider Details

I. General information

NPI: 1952734741
Provider Name (Legal Business Name): MID AMERICA PHYSICIAN SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2013
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9301 W 74TH ST STE 325
SHAWNEE MISSION KS
66204-2281
US

IV. Provider business mailing address

8801 MONROVIA ST
LENEXA KS
66215-3540
US

V. Phone/Fax

Practice location:
  • Phone: 913-384-4990
  • Fax:
Mailing address:
  • Phone: 913-318-1076
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: WHITNEY M RENTROP
Title or Position: CREDENTIALING SPECIALIST
Credential:
Phone: 913-318-1024