MEDICARE: BARBARA L GROENING OTR

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	225X00000X	Occupational Therapist	000809	MO
2	225X00000X	Occupational Therapist	17-00121	KS

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4603970001	OTHER	KS	MEDICARE DMERC

General Provider Information

NPI Number	:	1699776807
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BARBARA L GROENING OTR

Provider Business Mailing Address
First Line	:	8900 STATE LINE RD
Second Line	:	STE 333
City	:	LEAWOOD
State	:	KS
Zip	:	66206-1941
Country	:	US
Telephone Number	:	913-491-9404
Fax Number	:	913-754-0365

Provider Business Practice Location Address
First Line	:	8900 STATE LINE RD
Second Line	:	STE 333
City	:	LEAWOOD
State	:	KS
Zip	:	66206-1941
Country	:	US
Telephone Number	:	913-491-9404
Fax Number	:	913-754-0365

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

Provider Enumeration Date	:	08/10/2005
Last Update Date	:	01/13/2012

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Directions to “ BARBARA L GROENING OTR” Practice Location

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