MEDICARE: CARONDELET EMERGENCY PHYSICIANS INC

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	207P00000X	Emergency Medicine Physician	MD100341	MO

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	CU0181	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	140684700	OTHER	IL	ST JOSEPH'S FEDERAL WC
2	13247011	OTHER	MO	BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558363838
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARONDELET EMERGENCY PHYSICIANS INC

Provider Business Mailing Address
First Line	:	PO BOX 11347
Second Line	:
City	:	DAYTONA BEACH
State	:	FL
Zip	:	32120-1347
Country	:	US
Telephone Number	:	386-274-7800
Fax Number	:	386-274-7801

Provider Business Practice Location Address
First Line	:	1000 CARONDELET DR
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64114-4673
Country	:	US
Telephone Number	:	816-942-4400
Fax Number	:

Authorized Official
Title or Position	:	PRESIDNET
Name	:	PATRICK GREENWOOD
Credential	:	MD
Telephone Number	:	816-942-4400

Provider Enumeration Date	:	06/01/2005
Last Update Date	:	04/25/2011

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1972390110 — MEHREEN ASHFAQ MD
Practice Location Address:

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1831194901 — DR. JAMES ROBERT BERGH MD
Practice Location Address:

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1891793238 — LISA KATHLEEN CAST CRNA
Practice Location Address:

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Directions to “CARONDELET EMERGENCY PHYSICIANS INC ” Practice Location

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