Healthcare Provider Details

I. General information

NPI: 1619894102
Provider Name (Legal Business Name): ADVENTHEALTH CENTRA CARE OF KANSAS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/04/2026
Last Update Date: 07/04/2026
Certification Date: 07/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11245 SHAWNEE MISSION PKWY
SHAWNEE KS
66203-3308
US

IV. Provider business mailing address

2600 WESTHALL LN STE 300
MAITLAND FL
32751-7107
US

V. Phone/Fax

Practice location:
  • Phone: 913-268-4455
  • Fax:
Mailing address:
  • Phone: 407-200-2300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MATTHEW BRICE
Title or Position: CFO
Credential:
Phone: 407-200-2839