MEDICARE: SAGE FEMME BIRTH CENTER OF KANSAS CITY, 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	363LX0001X	Obstetrics & Gynecology Nurse Practitioner	0056403004	KS

General Provider Information

NPI Number	:	1659426005
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAGE FEMME BIRTH CENTER OF KANSAS CITY, INC.

Provider Business Mailing Address
First Line	:	721 N 31ST ST
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66102-3964
Country	:	US
Telephone Number	:	913-281-6457
Fax Number	:	913-281-6474

Provider Business Practice Location Address
First Line	:	721 N 31ST ST
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66102-3964
Country	:	US
Telephone Number	:	913-281-6457
Fax Number	:	913-281-6474

Authorized Official
Title or Position	:	CEO
Name	:	MRS. CATHERINE GORDON
Credential	:
Telephone Number	:	913-371-9966

Provider Enumeration Date	:	01/24/2007
Last Update Date	:	08/22/2020

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