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NPI Code Detail

MEDICARE: JYOTSNA ADMA M.D.

MEDICARE: JYOTSNA ADMA M.D.
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
12084P0800XPsychiatry Physician0431379KS
22084P0804XChild & Adolescent Psychiatry Physician036.153640IL
32084P0804XChild & Adolescent Psychiatry Physician2007012222MO
42084P0804XChild & Adolescent Psychiatry Physician0431379KS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1036.153640OTHERILILLINOIS LICENSE

General Provider Information

NPI Number : 1245457217
Entity Type Code : Individual
Provider Name (Legal Business Name) : JYOTSNA ADMA M.D.
Provider Business Mailing Address
First Line : 15316 PERRY ST
Second Line :
City : OVERLAND PARK
State : KS
Zip : 66221-7504
Country : US
Telephone Number : 913-962-1398
Fax Number :
Provider Business Practice Location Address
First Line : 4300 BRENNER DR
Second Line :
City : KANSAS CITY
State : KS
Zip : 66104-1163
Country : US
Telephone Number : 913-890-7400
Fax Number : 913-334-0284
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/19/2007
Last Update Date : 03/31/2022

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