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NPI Code Detail

MEDICARE: KANSAS CITY CARE CLINIC

MEDICARE: KANSAS CITY CARE CLINIC
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
1261QF0400XFederally Qualified Health Center (FQHC)

Other Identifiers

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

General Provider Information

NPI Number : 1396101317
Entity Type Code : Organization
Provider Name (Legal Business Name) : KANSAS CITY CARE CLINIC
Provider Business Mailing Address
First Line : 3515 BROADWAY BLVD
Second Line :
City : KANSAS CITY
State : MO
Zip : 64111-2501
Country : US
Telephone Number : 816-753-5144
Fax Number :
Provider Business Practice Location Address
First Line : 2340 E MEYER BLVD STE 208
Second Line :
City : KANSAS CITY
State : MO
Zip : 64132-1121
Country : US
Telephone Number : 816-753-5144
Fax Number : 855-737-0585
Authorized Official
Title or Position : DIRECTOR OF CREDENTIALING
Name : DEBBIE SKAGGS
Credential :
Telephone Number : 816-777-2761
Provider Enumeration Date : 01/06/2016
Last Update Date : 09/21/2022

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1851738975 — DR. ANDREW C MEDLIN DDS
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1992154355 — DR. ALEXIS NICOLE RICKEL D.D.S.
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Practice Fax:
1861841660 — MR. GEORGE YEUNG-FWU CHOU D.O.
Practice Location Address:
2340 E MEYER BLVD STE 200
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Practice Fax:
1316675317 — KANSAS CITY CARE CLINIC
Practice Location Address:
2340 E MEYER BLVD STE 208
KANSAS CITY, MO
64132-1121
Practice Phone: 816-753-5144
Practice Fax: 855-737-0585

Directions to “KANSAS CITY CARE CLINIC ” Practice Location

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