MEDICARE: JAMES E POWELL MS

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	231H00000X	Audiologist	802	KS
2	231H00000X	Audiologist	605	MO
3	237700000X	Hearing Instrument Specialist	CE564	KS
4	237700000X	Hearing Instrument Specialist	000397	MO

General Provider Information

NPI Number	:	1790755486
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES E POWELL MS

Provider Business Mailing Address
First Line	:	8901 W 74TH ST # 150
Second Line	:
City	:	SHAWNEE MISSION
State	:	KS
Zip	:	66204-2282
Country	:	US
Telephone Number	:	913-384-5880
Fax Number	:	913-384-9612

Provider Business Practice Location Address
First Line	:	9535 STATE AVE
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66111-1815
Country	:	US
Telephone Number	:	913-334-5621
Fax Number	:	913-384-9612

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

Provider Enumeration Date	:	01/25/2006
Last Update Date	:	11/14/2007

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