Healthcare Provider Details

I. General information

NPI: 1558474312
Provider Name (Legal Business Name): KIMBERLY KAY CATER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/16/2006
Last Update Date: 09/17/2021
Certification Date: 09/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 S US HIGHWAY 169
SMITHVILLE MO
64089-9317
US

IV. Provider business mailing address

901 E. 104TH ST MAILSTOP 400N
KANSAS CITY MO
64131
US

V. Phone/Fax

Practice location:
  • Phone: 816-532-3999
  • Fax: 816-532-4465
Mailing address:
  • Phone: 816-532-3999
  • Fax: 816-532-4465

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number105461
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: