Healthcare Provider Details

I. General information

NPI: 1982295309
Provider Name (Legal Business Name): KIMBERLYNN GABRIELLE CASS PA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KIMBERLYNN GABRIELLE THOMAS

II. Dates (important events)

Enumeration Date: 01/28/2021
Last Update Date: 12/26/2025
Certification Date: 12/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2906 NW VIVION RD
RIVERSIDE MO
64150-1502
US

IV. Provider business mailing address

3801 DR MARTIN LUTHER KING JR BLVD
KANSAS CITY MO
64130-2807
US

V. Phone/Fax

Practice location:
  • Phone: 816-599-5051
  • Fax:
Mailing address:
  • Phone: 816-923-5800
  • Fax: 816-922-1070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number2022032222
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number15-02669
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: