MEDICARE: IMAGING FOR WOMEN LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician	36717	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	217588	OTHER		MAMM CERTIFICATION#
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	24320015	OTHER	MO	KCBCBS GROUP ID#

General Provider Information

NPI Number	:	1023236171
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IMAGING FOR WOMEN LLC

Provider Business Mailing Address
First Line	:	630 NW ENGLEWOOD RD
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64118-3973
Country	:	US
Telephone Number	:	816-453-2700
Fax Number	:	816-453-9943

Provider Business Practice Location Address
First Line	:	630 NW ENGLEWOOD RD
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64118-3973
Country	:	US
Telephone Number	:	816-453-2700
Fax Number	:	816-453-9943

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MS. ASHLEY BLACKETER
Credential	:
Telephone Number	:	816-268-3305

Provider Enumeration Date	:	04/23/2007
Last Update Date	:	09/02/2025

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Directions to “IMAGING FOR WOMEN LLC ” Practice Location

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