Healthcare Provider Details

I. General information

NPI: 1306363858
Provider Name (Legal Business Name): CHILDREN'S MERCY - REDWOOD PEDIATRICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2017
Last Update Date: 04/22/2025
Certification Date: 04/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9784 N ASH AVE
KANSAS CITY MO
64157-9742
US

IV. Provider business mailing address

2401 GILLHAM ROAD PROVIDER ENROLLMENT DEPT
KANSAS CITY MO
64108-4619
US

V. Phone/Fax

Practice location:
  • Phone: 816-207-0070
  • Fax: 816-256-2806
Mailing address:
  • Phone: 816-701-5200
  • Fax: 816-302-9939

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2010037363
License Number StateMO

VIII. Authorized Official

Name: ROBERT D FINUF II
Title or Position: SENIOR VICE PRESIDENT
Credential:
Phone: 816-701-5200