MEDICARE: ANDREW CARL SHORE

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	208000000X	Pediatrics Physician	2022027327	MO
2	207R00000X	Internal Medicine Physician	2022027327	MO

General Provider Information

NPI Number	:	1174028120
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREW CARL SHORE

Provider Business Mailing Address
First Line	:	2906 NW VIVION RD
Second Line	:
City	:	RIVERSIDE
State	:	MO
Zip	:	64150-1502
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2906 NW VIVION RD
Second Line	:
City	:	RIVERSIDE
State	:	MO
Zip	:	64150-1502
Country	:	US
Telephone Number	:	816-599-5050
Fax Number	:

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

Provider Enumeration Date	:	03/29/2018
Last Update Date	:	09/08/2022

Similar Medicare Providers

1356339279 — KENDALLWOOD HOSPICE COMPANY
Practice Location Address:

2908 NW VIVION RD
RIVERSIDE, MO
64150-1502

Practice Phone: 816-587-1000
Practice Fax: 816-587-3000

1023004009 — DOROTHY JEAN JACKSON MD
Practice Location Address:

2906 NW VIVION RD
KANSAS CITY, MO
64150-1502

Practice Phone: 816-599-5050
Practice Fax:

1396488581 — CAROLINE RODRIGUEZ
Practice Location Address:

159 GOLDFINCH LN
RIVERSIDE, CA
92507-1502

Practice Phone: 951-966-8467
Practice Fax:

1356229942 — MIMI MEDICAL SUPPLY LLC
Practice Location Address:

1905 W RIVERSIDE BLVD
ROCKFORD, IL
61103-1502

Practice Phone: 872-702-3523
Practice Fax:

1962450569 — SPINE & EXTREMITY REHABILITATION CENTER OF KANSAS CITY NORTH INC
Practice Location Address:

220 NW PLATTE VALLEY DR
RIVERSIDE, MO
64150-9793

Practice Phone: 816-505-3422
Practice Fax: 816-505-3312

1801847124 — ROBERT ALAN MITCHELL PT, BSPT
Practice Location Address:

220 NW PLATTE VALLEY DR
RIVERSIDE, MO
64150-9793

Practice Phone: 816-741-6374
Practice Fax: 816-505-3312

Directions to “ ANDREW CARL SHORE ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.