1023210556 NPI number — GEORGE S DEVINS

Table of content: (NPI 1023210556)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023210556 NPI number — GEORGE S DEVINS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GEORGE S DEVINS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1023210556
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/21/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6724 TROOST AVE
Provider Second Line Business Mailing Address:
STE 304
Provider Business Mailing Address City Name:
KANSAS CITY
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
64131-1500
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
816-363-0787
Provider Business Mailing Address Fax Number:
816-363-5090

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6724 TROOST AVE
Provider Second Line Business Practice Location Address:
STE 304
Provider Business Practice Location Address City Name:
KANSAS CITY
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64131-1500
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-363-0787
Provider Business Practice Location Address Fax Number:
816-363-5090
Provider Enumeration Date:
06/05/2007

Additional Information

Authorized Official

Authorized Official Last Name:
DEVINS
Authorized Official First Name:
GEORGE
Authorized Official Middle Name:
S
Authorized Official Title or Position:
OWNER DOCTOR
Authorized Official Telephone Number:
816-363-0787

Provider Taxonomy Codes

  • Taxonomy code: 207K00000X , with the licence number:  28935 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 49-7389501 . This is a "TAX ID#" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: A970470A . This is a "MEDICARE PROVIDER NUMBER" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: A970470C . This is a "MEDICARE PROVIDER NUMBER" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 1023084969 . This is a "NPI NUMBER" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 110037923 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: $$$$$$$$$ . This is a "SSN" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 1023210556 . This is a "NPI GROUP" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 1568655108 . This is a "NPI GROUP NUMBER" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 200173920 . This is a "MEDICAID GROUP NUMBER" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 507676013 . This is a "MEDICAID GROUP" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 1023084969 . This is a "NPI NUMBER" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 110038097 . This is a "RAILROAD MEDICARE NUMBER" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 507676005 , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".




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