Provider Demographics
NPI:1063460079
Name:SIMON, CATHERINE ONG (MD)
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:ONG
Last Name:SIMON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CATHERINE
Other - Middle Name:MARIE
Other - Last Name:ONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:14814 GRANADA CT
Mailing Address - Street 2:
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66224-3941
Mailing Address - Country:US
Mailing Address - Phone:913-814-9942
Mailing Address - Fax:816-234-3701
Practice Address - Street 1:2401 GILLHAM
Practice Address - Street 2:CHILDREN'S MERCY HOSPITAL
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64108
Practice Address - Country:US
Practice Address - Phone:816-234-3250
Practice Address - Fax:816-234-3701
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2015-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOMDR9J302080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO203397617Medicaid
KS2050375101Medicaid
MOF47762Medicare UPIN
KS2050375101Medicaid