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1285733923

NPI Code Detail

MEDICARE: EXCELSIOR SPRINGS CITY HOSPITAL

MEDICARE: EXCELSIOR SPRINGS CITY HOSPITAL

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
2	2084P0800X	Psychiatry Physician
3	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility		MO
4	207L00000X	Anesthesiology Physician		MO
5	207Q00000X	Family Medicine Physician	119789	MO
6	207X00000X	Orthopaedic Surgery Physician		MO
7	207P00000X	Emergency Medicine Physician

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

General Provider Information

NPI Number	:	1285733923
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EXCELSIOR SPRINGS CITY HOSPITAL

Provider Business Mailing Address
First Line	:	1700 RAINBOW BLVD
Second Line	:
City	:	EXCELSIOR SPRINGS
State	:	MO
Zip	:	64024-1182
Country	:	US
Telephone Number	:	816-630-6081
Fax Number	:	816-629-2707

Provider Business Practice Location Address
First Line	:	1700 RAINBOW BLVD
Second Line	:
City	:	EXCELSIOR SPRINGS
State	:	MO
Zip	:	64024-1182
Country	:	US
Telephone Number	:	816-630-6081
Fax Number	:	816-629-2707

Authorized Official
Title or Position	:	CHIEF FINANCIAL OFFICER
Name	:	CAMERON MEYER
Credential	:
Telephone Number	:	816-629-2763

Provider Enumeration Date	:	09/21/2006
Last Update Date	:	01/05/2023

Similar Medicare Providers

1609870310 — EXCELSIOR SPRINGS CITY HOSPITAL
Practice Location Address:

1700 RAINBOW BLVD
EXCELSIOR SPRINGS, MO
64024-1182

Practice Phone: 816-630-6081
Practice Fax: 816-629-2707

1346237120 — CARL E LEDBETTER DO
Practice Location Address:

1700 RAINBOW BLVD
EXCELSIOR SPRINGS, MO
64024-1182

Practice Phone: 816-630-6081
Practice Fax: 816-629-3661

1467436626 — SUTHON CHATKUPT M.D.
Practice Location Address:

1700 RAINBOW BLVD
EXCELSIOR SPRINGS, MO
64024-1182

Practice Phone: 816-629-2743
Practice Fax: 816-629-2708

1518947696 — MEREDITH ADAIR LEACH M.D.
Practice Location Address:

1700 RAINBOW BLVD
EXCELSIOR SPRINGS, MO
64024-1182

Practice Phone: 816-630-6081
Practice Fax:

1376501684 — MRS. KAREN MYCANKA OTR CHT CLT
Practice Location Address:

1700 RAINBOW BLVD
EXCELSIOR SPRINGS, MO
64024-1182

Practice Phone: 816-629-2700
Practice Fax: 816-629-2723

1740387174 — EXCELSIOR SPRINGS CITY HOSPITAL
Practice Location Address:

1700 RAINBOW BLVD
EXCELSIOR SPRINGS, MO
64024-1182

Practice Phone: 816-630-6081
Practice Fax: 816-629-2707

Directions to “EXCELSIOR SPRINGS CITY HOSPITAL ” 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.

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