Healthcare Provider Details

I. General information

NPI: 1396709127
Provider Name (Legal Business Name): ROCKHILL PAIN SPECIALISTS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2006
Last Update Date: 08/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6675 HOLMES RD
KANSAS CITY MO
64131
US

IV. Provider business mailing address

10561 BARKLEY SUITE 610
OVERLAND PARK KS
66212-1835
US

V. Phone/Fax

Practice location:
  • Phone: 816-276-7094
  • Fax: 816-276-7816
Mailing address:
  • Phone: 913-754-0641
  • Fax: 913-754-0646

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. SHIRLEY ANN DEHARDT
Title or Position: BILLING ADMINISTRATOR
Credential: RN MBA
Phone: 913-754-0641