Healthcare Provider Details

I. General information

NPI: 1447751375
Provider Name (Legal Business Name): CHILDREN'S MERCY-SUMMIT PEDIATRICS & ADOLESCENT MEDICINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2018
Last Update Date: 04/18/2025
Certification Date: 04/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3171 NE CARNEGIE DR STE A
LEES SUMMIT MO
64064-3226
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 816-525-2800
  • Fax: 816-525-4077
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 Number
License Number State

VIII. Authorized Official

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