1942242672 NPI number — DR. ANDREW LAURONILLA MD

Table of content: DR. ANDREW LAURONILLA MD (NPI 1942242672)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942242672 NPI number — DR. ANDREW LAURONILLA MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LAURONILLA
Provider First Name:
ANDREW
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
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:
1942242672
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/01/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6000 LAMAR AVE STE 130
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MISSION
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
66202-3234
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
913-826-4200
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1125 W SPRUCE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OLATHE
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66061-3123
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
913-826-4200
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/10/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2084P0800X , with the licence number:  04-27867 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 2068914 . This is a "CIGNA" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 9602 . This is a "PREFERRED HEALTH SYSTEMS" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 104024 . This is a "BLUE CROSS" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".




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