MEDICARE: REGAN SHAFFER PA-C

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	363A00000X	Physician Assistant	15-02618	KS
2	363A00000X	Physician Assistant	PA12677	TX
3	363A00000X	Physician Assistant	2022006989	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053877258
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REGAN SHAFFER PA-C

Provider Business Mailing Address
First Line	:	4000 CAMBRIDGE ST STE G600
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66160-8501
Country	:	US
Telephone Number	:	913-588-1227
Fax Number	:

Provider Business Practice Location Address
First Line	:	4000 CAMBRIDGE ST STE G600
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66160-8501
Country	:	US
Telephone Number	:	913-588-1227
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/13/2019
Last Update Date	:	02/04/2026

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Directions to “ REGAN SHAFFER PA-C” Practice Location

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