MEDICARE: SHAWN BERRY SOOD MD MBA

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	2080P0203X	Pediatric Critical Care Medicine Physician	2023029204	MO
2	2080P0203X	Pediatric Critical Care Medicine Physician	04-44868	KS
3	2080P0203X	Pediatric Critical Care Medicine Physician	31444	OK

General Provider Information

NPI Number	:	1699161778
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAWN BERRY SOOD MD MBA

Provider Business Mailing Address
First Line	:	2106 OLATHE BLVD MAILSTOP 4004
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66160-0001
Country	:	US
Telephone Number	:	913-588-5000
Fax Number	:

Provider Business Practice Location Address
First Line	:	4000 CAMBRIDGE ST
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66160-2527
Country	:	US
Telephone Number	:	913-588-5000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/15/2015
Last Update Date	:	05/21/2024

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