Healthcare Provider Details

I. General information

NPI: 1659806453
Provider Name (Legal Business Name): GREINER ORTHOPEDICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2017
Last Update Date: 09/19/2024
Certification Date: 09/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19201 E VALLEY VIEW PKWY STE C
INDEPENDENCE MO
64055-6913
US

IV. Provider business mailing address

4941 NW CANYON RD
LEES SUMMIT MO
64064-2066
US

V. Phone/Fax

Practice location:
  • Phone: 816-317-5070
  • Fax: 855-862-9292
Mailing address:
  • Phone: 816-317-5070
  • Fax: 816-205-8282

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number2006015219
License Number StateMO

VIII. Authorized Official

Name: JESSIKA N MILLER
Title or Position: ASSISTANT MANAGER
Credential:
Phone: 816-647-2251