Providence Medical Group

LBN: Prime Healthcare Physician Services - Providence Inc
Providence Medical Group is an health care organization with primary practice located at 16663 Midland Dr Ste 100 , Shawnee KS 66217-3042. The organization recently has 14 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery, Allopathic & Osteopathic Physicians / Anesthesiology, Allopathic & Osteopathic Physicians / Pain Medicine, Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Gastroenterology, Allopathic & Osteopathic Physicians / Female Pelvic Medicine and Reconstructive Surgery, Allopathic & Osteopathic Physicians / Orthopaedic Surgery, Allopathic & Osteopathic Physicians / Undersea and Hyperbaric Medicine, Allopathic & Osteopathic Physicians / Neurology, Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Pediatric Surgery, Allopathic & Osteopathic Physicians / General Practice. Allopathic & Osteopathic Physicians / General Practice is the primary health care specialty. Prime Healthcare Physician Services - Providence Inc can be contacted via phone (913) 631-2600, or through Doan, Christopher via phone (310) 259-4706.

Contact Information

Primary practice address
16663 Midland Dr Ste 100 Shawnee KS 66217-3042
Phone: (913) 631-2600
Fax: (913) 631-2606
Website:
Map and Directions
Authorized official contact:
Name: Doan, Christopher
Phone: (310) 259-4706

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery 204E00000X
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X
Allopathic & Osteopathic Physicians / Pain Medicine 207LP2900X
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X
Allopathic & Osteopathic Physicians / Female Pelvic Medicine and Reconstructive Surgery 207VF0040X
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X
Allopathic & Osteopathic Physicians / Undersea and Hyperbaric Medicine 2083P0011X
Allopathic & Osteopathic Physicians / Neurology 2084N0400X
Allopathic & Osteopathic Physicians / Surgery 208600000X
Allopathic & Osteopathic Physicians / Pediatric Surgery 2086S0120X
Allopathic & Osteopathic Physicians / General Practice 208D00000X

Profile Details

NPI number 1356683213
LBN Legal business name Prime Healthcare Physician Services - Providence Inc
DBA Doing business as Providence Medical Group
Authorized official Doan, Christopher
Entity Organization
Organization subpart 1 Yes
Enumeration date Mar 19th, 2013
Last updated Aug 1st, 2023 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356683213 NPPES
Kansas MEDICAID 201193920H
Kansas MEDICAID 500017218

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