Provider Demographics
NPI:1134121379
Name:HEALTH ADMINISOURCE, L.L.C.
Entity Type:Organization
Organization Name:HEALTH ADMINISOURCE, L.L.C.
Other - Org Name:KANSAS CITY PHYSICAL THERAPY GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:A
Authorized Official - Last Name:DUNCAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-384-5600
Mailing Address - Street 1:5799 BROADMOOR ST
Mailing Address - Street 2:STE 300
Mailing Address - City:MISSION
Mailing Address - State:KS
Mailing Address - Zip Code:66202-2421
Mailing Address - Country:US
Mailing Address - Phone:913-384-5600
Mailing Address - Fax:
Practice Address - Street 1:5799 BROADMOOR ST
Practice Address - Street 2:STE 300
Practice Address - City:MISSION
Practice Address - State:KS
Practice Address - Zip Code:66202-2421
Practice Address - Country:US
Practice Address - Phone:913-384-5600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-01
Last Update Date:2008-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS14112990OtherU.S. DEPT OF LABOR
731060OtherHEALTHCARE PREFERRED
8271336OtherAETNA PROVIDER NUMBER
16278037OtherBLUE CROSS BLUE SHIELD
MOT660000AOtherMEDICARE PART B
4000127OtherMULTIPLAN PROVIDER NUMBER
KST660000OtherMEDICARE PART B
MO14112991OtherU.S. DEPT OF LABOR
440660OtherHEALTHLINK PROVIDER NUMBE
KS534021OtherBLUE CROSS BLUE SHIELD KS
6400222OtherUNITED HEALTHCARE PROVIDE