MEDICARE: ODYSSEY HEALTHCARE OF KANSAS CITY, 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	251G00000X	Community Based Hospice Care Agency

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	:	1073514600
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ODYSSEY HEALTHCARE OF KANSAS CITY, LLC

Provider Business Mailing Address
First Line	:	PO BOX 4060
Second Line	:
City	:	MOORESVILLE
State	:	NC
Zip	:	28117-4060
Country	:	US
Telephone Number	:	913-814-2013
Fax Number	:

Provider Business Practice Location Address
First Line	:	8414 N. CHURCH ROAD
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64157-1204
Country	:	US
Telephone Number	:	816-795-1333
Fax Number	:	816-795-1711

Authorized Official
Title or Position	:	VP OF LICENSURE
Name	:	JANET COMBS
Credential	:
Telephone Number	:	704-662-1761

Provider Enumeration Date	:	08/04/2005
Last Update Date	:	12/04/2025

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