Healthcare Provider Details

I. General information

NPI: 1558733766
Provider Name (Legal Business Name): CORE MEDICAL CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2015
Last Update Date: 12/20/2019
Certification Date: 12/20/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1131 W MAIN ST
BLUE SPRINGS MO
64015-3611
US

IV. Provider business mailing address

1131 W MAIN ST
BLUE SPRINGS MO
64015-3611
US

V. Phone/Fax

Practice location:
  • Phone: 816-229-1941
  • Fax: 816-229-7085
Mailing address:
  • Phone: 913-742-0177
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateNULL
# 4
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. ASTON MICHAEL GOLDSWORTHY
Title or Position: OWNER
Credential: DC, MSN, FNP-BC
Phone: 816-229-1941