=====================================================
General NPI Number Information
=====================================================
NPI Number | 1871720078
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WOMEN'S CENTER AT BROOKSIDE, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/15/2009
-----------------------------------------------------
Last Update Date | 11/20/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6675 HOLMES RD SUITE 300
-----------------------------------------------------
City | KANSAS CITY
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 64131-1150
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 816-333-5005
-----------------------------------------------------
Fax | 816-333-6351
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2000 HEALTH PARK DR # 0
-----------------------------------------------------
City | BRENTWOOD
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37027-4692
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 615-373-7406
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | GROUP VICE PRESIDENT
-----------------------------------------------------
Name | BENJAMIN CALKINS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 615-372-6536
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207V00000X
-----------------------------------------------------
Taxonomy Name | Obstetrics & Gynecology Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------